Katie's story - breastfeeding after fertility treatment

Katie had a difficult route to pregnancy, going through two rounds of IVF and several transfers, as well as multiple surgeries to prepare her for conception. Her story is one of struggle, but also of trusting her instincts to continue. Did her route to conception give her more determination to make breastfeeding work? After a c-section delivery, her daughter, Ava, struggled to latch with a high palate, but with the help of nipple shields and pumping, they made it through. Now a year on, Ava feeds well and Katie has no plans to stop soon.

You can follow Katie on Instagram at @k_comer82

She recommends these instagram accounts on endometriosis:

@gynaegeek

@endometriosis.surgeon.uk

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  00:46

Thank you very much for joining me for today's episode, I am with Katie, Katie Comer, as you will have seen from the title, we're talking about the experience of breastfeeding after fertility treatment, and after having had an assisted conception. And I know, for some mums that can put breastfeeding in a different light. And Breastfeeding can have a new significance because of that. I'm not saying that's everyone's universal experience. But that's what we're going to be touching on today. And Katie is very generously going to be sharing her story. Thank you very much for joining me today, Katie.

Katie Comer  01:17

Thank you for having me. I'm really pleased to speak to you today.

Emma Pickett  01:20

So you are mom of Ava, who's 14 months. That's right. And before we talk about your breastfeeding journey, tell me about your journey of getting over to join the world.

Katie Comer  01:32

Well, I always knew that I might have problems conceiving, because I have for a number of years been treated for very severe and endometriosis. And I've had some failed surgeries that they discussed that if I did want to conceive the six months after that surgery would be a good time and then that surgery failed. And they couldn't even access my body the part of my body they needed to 

Emma Pickett  02:02

when you say they couldn't access it, Katie I mean, do tell me if I'm asking intrusive questions, but it basically it was they couldn't open you up because there was so severe the endometriosis so severe is that what you mean?

Katie Comer  02:13

It was a combination of really severe and endometriosis causing a lot of adhesions and scarring. But also my medical history from when I was an infant. So I was born with exam pulis, which means that my, some of my internal organs were sort of outside my body in a sack, when I was born, I can see essentially a hole in my dominant wall. So when I was in utero, I had this sort of congenital defect, so it means I've got a lot of adhesions and scar and internally. And so the surgeons, it was keyhole surgery, and they literally couldn't get the instruments or the camera to the right part of my body to to my sort of William and ovaries, etc, to sort of do the work they wanted. So they literally couldn't get in there. And this relevant later because this is reason ended up having a C section as well. 

Emma Pickett  03:07

Yeah, fair enough, I think after that disruption. Yeah, I mean, that sounds so you had surgery, when you were very little did you, to put your organs back inside?

Katie Comer  03:15

So I had, I don't know how many I had a number surgeries is a baby and had one that's about three years old. The last one, and I remember that one, but I can't remember the others because I was literally a newborn baby. So I'd had because I've had multiple abdominal surgeries that then caused these adhesions, and then the endometriosis on top of that was even more scar tissue and adhesions inside me. So I was aware from the way that the surgeons talking, and this was even before I met my husband, that one day, if I wanted a child, it might be quite difficult for me. And also, I was told, if you ever do get pregnant, they advise a C section simply and you might think why would you want to put another domino surgery into that mix. But the reason was, because the way the doctor told me is 20% of labour's like natural labour's will end up in a C section. And that what they didn't want is for me to have an emergency C section. Free am when it's whatever doctors on call, who doesn't know my medical history and they have to go very quickly to get the baby out. So they said we want you to have a very calm planned C section of a specialist surgeon who knows your anatomy and that kind of thing.

Emma Pickett  04:30

That makes sense. So you need that surgical expertise essentially you were not okay you are not a candidate for whoever was on call that day.

Katie Comer  04:36

Yeah. And you know, as well as a scar in there was my organs because of I guess, because of how things developed when I was a baby. My organs were not like exactly the same place as everyone else's. So my describe my levers almost like a curtain, Jack in front of the front of my belly. So you know, there'll be a chance that my liver could become damaged could damage my bowel or my bladder or something like that in, in a situation where they've got to get the baby out in 20 minutes, for example, that wouldn't be that safe for me. 

Emma Pickett  05:08

Okay, so before you even met your husband, you had a sense that fertility might be something that was challenging for you. Yes. How soon after you met your husband? Did you decide that you wanted to have children and have a good conceiving? 

Katie Comer  05:22

So this is going to be from the listener, the listeners, that sounds a little bit that mad. So we started trying, probably about six months after we met. Because I was very honest with him about it, it's gonna be difficult. So it's gonna take a while, probably for me to get pregnant. And I was 35. And I met my husband. And that's fair to six, we start to try for baby. And we sort of knew quite early on that we weren't going to get married one day, and that we just knew we were the right person. I wouldn't normally advise people to start trying for baby six months into a relationship. 

Emma Pickett  05:57

You know what, I don't think it matters? To me, I think you everyone has their own timeline. And I, I when you said that this is gonna sound mad. I thought you were talking about you know, date number two, we were talking about six months sounds quite grown up and reasonable to me. But you know, who has anyone else to ever judge? As you say, if you found your person, you know, it's right for you. 

Katie Comer  06:16

And I'm so glad we did. Because the journey took quite some time if you're here, so yeah. So when when we first met as well, I was having a sort of hormonal treatment to try and help with the endometriosis symptoms. So I had to stop that as well. Which meant that this is a problem of endometriosis for anyone listening who suffers from it. And it's like one in 10 women or something that you're desperate, you know, if you want to have a baby, and you're thinking about your fertility, obviously, you can't be taking any kind of contraceptive, hormonal contraceptive or any hormonal treatment for your endometriosis. And then so that makes them worse. 

Emma Pickett  06:54

Okay, so so just to clarify, because I don't know a lot about endometriosis. So some people do take like oestrogen or combined contraceptive pills to reduce the symptoms. Yes. So to be able, obviously, to be able to conceive, you then have to stop that. So you've potentially got several months where your symptoms are really flaring up, and you're struggling even more.

Katie Comer  07:13

Exactly. So yeah, the treatment I was on before I was on the floor while I was on the concept of pill and then I had some some hormonal injections that essentially just sort of put you into like a sort of temporary menopause for want of a better expression. So you don't have any periods. And then that hugely reduce your symptoms, because because not all of the pain, but most of the pain is around your periods. So for a lot of women, the treatment is to go on the pill, because that reduces the heaviness of your periods and also the pain. And so obviously, if you're trying to have baby, you don't want to have any of that happening. And also during IVF you can't have any hormonal treatments. So I come off that which meant that I was having very severe symptoms, I mean, can't get out of bed severe symptoms. Anyway, so we decided we want to try for baby. So I was seeing some consultants at the time about my endometriosis as well. And the surgeon who had tried to do the surgery, but couldn't referred me to another consultant. And he was also an IVF. Doctor. And so when I saw him, he was like, What is your priority right now? And by that he means is it pain management? Is it fertility, etc. And I did say fertility. And he said, Try for six months. And if nothing happens, we'll have another look, we're lucky. And I did try for six months, nothing happened. We went back, I had some scans done which I can never pronounce the word. But essentially, it's a scan where they put her sort of a die like into your uterus and up for your fallopian tubes to see if your fallopian tubes are blocked. And what they found out is discovered was really bad. And both my fallopian tubes were blocked. And they're very swollen full of fluid. So essentially, I was never going to conceive naturally, they described it as a meeting problem, like the sperm or the egg, we're never gonna get together. 

Emma Pickett  09:10

Okay, so six months, and I can sort of understand why you can't scan everybody immediately. Obviously, the NHS would, you know, it'd be very difficult to do that. But it does feel like you should have been someone that should have been entitled to that. I mean, six months are very severe. Endometriosis is life changing. I mean, you're talking about being in incredible pain and I'm so sorry that that's your experience that you had to go through that, that six months of suffering before you then find out that those six months were never going to result in conception must have been pretty tough going I guess in one way it was good to have an answer but also that six months of pain for for no purpose.

Katie Comer  09:46

I mean, I've just I've used that to finish with essay and I was never going to get pregnant. If you'd ask a doctor they always say Never say never. They always say there's always these women where we look at them and you think that's not gonna happen and they do get pregnant but you know Looking back, because it wasn't just a six month we were trying obviously, in between all the IVF and weight of everything, we it was probably a few years of trying naturally in between after this treatment. So that's probably why but it was very frustrating, especially you feel at the clock ticking, you know. And anyway, so to make things more complicated, so the treatment, the standard treatment for somebody who had fallopian tubes established as mine is to remove those tubes and have IVF. However, because they couldn't get, they knew that they wouldn't be able to access that part of my body with the instruments for keyhole surgery, that wasn't an option for me to have my fallopian tubes removed. So this is where things were a little bit lucky because this doctor had that it was a specialist in an ABA treatment, which was, and it sounds really bad, but a cauterise in the end of my fallopian tubes, okay, so essentially, they don't go into the abdomen, they'll go up through the cervix, like sort of up the vagina for the cervix. And they have a little instrument. And it will, I guess, like a laser, I'm not totally sure, if a doctor listening, but essentially, they want my the end of my flow continues to be blocked. The slight scar scarred over and blocked. Okay. And the reason for that is the fluid that builds up in the APM tubes. If that gets into the uterus, that essentially would stop any potentially be toxic to an embryo or stop an embryo attaching. So it would mean the IVF is less likely to happen. I was told if I had the surgery, and it worked, my chances would then be the same as any other woman having IVF in that situation. So then I was on a waiting list to have that surgery. So again, all the time, said, they did say to keep trying, and I had surgery, then I started IVF Oh, and I hope this is okay. But just for anybody listening who's either in the military or their partner is in the military, I did wasn't eligible. postcode lottery that is IVF on the NHS, I wasn't eligible for funding. Because of my age, because I'm over the age of 35. And where I lived at the time, there wasn't funding available for women over the age of 35. And also I if I was eligible, I'd only got one cycle. However, if you're in the armed forces, or if your partner is in the armed forces, you can't get NHS funding, because the Armed Forces covenant, and I didn't know about this, and my husband just happened to read an article in one of the RBF magazines that talks about this. And it's not something so I tell everyone who listens to me. And because of that, say because my husband's in the IVF, or what at the time, we got three rounds of IVF funded through the NHS.

Emma Pickett  12:45

Brilliant. And without that, I'm guessing. I mean, IVF is obviously super expensive. 

Katie Comer  12:50

So it was tough a lot of it. So we might have, if it wasn't for that fund, we might have given up sooner, we would have probably still gone for IVF. But I don't think we'd have had as much IVF if we did, because it would have felt like it was just too much, too much of a cost. 

Emma Pickett  13:04

So you had those three cycles, first of all funded on the NHS, and how did they go for you?

Katie Comer  13:10

So the first cycle, we only got one egg. The positive thing that came out of all my testing was, despite my challenges, I did have a good egg reserve. They told me and they hormonally everything was looking good. But because of my medical history, they were very conservative of the drugs they gave me to stimulate the production of eggs. So I only got the one egg the first time and they did make an embryo which we're very lucky because only 60% of eggs will be fertilised, but unfortunately had the transfer in that I wasn't pregnant didn't work. And then COVID-19 happened. So this was early 2020. 

Emma Pickett  13:50

That hits a lot of people's IVF experiences. I know that I'm sorry,

Katie Comer  13:54

exactly. So obviously we would have we should have started again. It was February, February 2020. Sorry, we had failed round. And we should have started again in April 2020. Obviously, that did not happen, because of all the IVF clinics shut. But we did start again in September. So it wasn't too bad of a delay. But it did delay it a few months ago, we luckily I didn't aged out during that time. So for some women, they would have turned 40 And then they may not be eligible anymore because the funding I had was three rounds, but only until I turned 40 Okay, so there are no I did hear, unfortunately about some women who, you know, have to have a birthday in that time and suddenly they weren't eligible for the funding anymore. Which is just really quite tragic to think about. Yeah, so start again that September, and then that time they increase my doses of drugs and we got a temporary those that were really good quality embryos. So happy days. We thought this is it. All the doctors are really positive. I clearly remember during one of the transfers, they're even saying oh, this is definitely gonna get you pregnant.

Emma Pickett  14:57

Oh crikey who says that in an IVF clinic that can't be common. 

Katie Comer  15:00

I know and they were just really because they were like, Look how lovely this embryo is. And I didn't. So just to summarise, so I had to further transfers every single embryo, because then they really want to avoid twins and multiple births with IVF, they have targets to have a maximum number of multiple births. So they are very conservative, they started off just transfer one embryo at a time. So I had two more embryos transferred one at a time, didn't work both times. And you always have a review after each failed cycle with the doctor where they talk about, you know, what we're gonna try differently? Or are we gonna try anything differently or what's gonna happen? And they just said, Oh, it's probably just bad luck, because obviously, not every embryo will be viable. So probably just bad luck that those embryos were going to develop anyway, and then had to a double transfer. So two embryos transferred at once, and failed, I guess, is

Emma Pickett  15:53

now no longer the NHS three rounds. So the three rounds of the NHS haven't worked at this point.

Katie Comer  16:00

No, it's a bit confusing because to around as defined by the NHS funding is a full cycle from when they collect the eggs, but it involves transferring and all the embryos 

Emma Pickett  16:12

I see. Okay, so all the embryos that you made are bound to if that makes sense. Okay, thank you for clarifying that. Okay. Okay. So an embryo transfer doesn't count as an attempt as it were. Okay. 

Katie Comer  16:21

Yeah. So any embryos, The only stipulation was I couldn't have an egg collection into alEid. Tried to transfer what those embryos. Okay, so technically, we're slowing down to both point and 40. So I wouldn't be eligible then for any more eggs to be collected anyway, at this point. So at this point, they're like, Okay, there's something happening, because we would expect this to work by now. The other factor, so the quality embryo, but also, like how they give you drugs to make your womb lining nice and thick and sort of ready for the embryo, I guess, for some women isn't picking up there? Well, but my womb, lining was picking it was looked really good on the scan. So like, it's no problem there, that looks good. And then they did say, we think baby should have a scan again, to look at your fallopian tubes to see if that surgery worked. And it turned out the surgery I had hadn't worked. So all this time, that was probably the problem that I was having this sort of fluid from my fallopian tubes, make him my womb, sort of not very hospitable for embryo. Okay. So sorry. So they then sent her a farewell letter. So even though I was NHS funded, I was at a private clinic for the, for the IVF. So they have to then send a farewell letter to the NHS hospital for me to have the surgery a second time to get to work this time. And this was, you know, I'm sure you saw the headlines after, you know, the NHS is on its knees, because of COVID. No blame to them. It was an unprecedented situation. But all you'd see on the news was, you know, these headlines about waiting lists for surgery for like electricity, and how long they were and how smart I was quite worried about how long it would take. You know, I think the first time I'd wait, and maybe six months after surgery, so I was thinking, well, it might be a year or something. 

Emma Pickett  18:02

Katie, can I just pause you for a second? You're very calmly describing all these procedures and setbacks and letters and waiting. And you know, I'm I'm just really aware that every time you're waiting, that's more cycles and more pain and more endometriosis. How are you? How are you doing emotionally during this period? How are you and your husband doing?

Katie Comer  18:21

Not great. I think I'm quite a strong person, in lots of ways. Lots of people and they talk about IVF, they talk about all you have to inject yourself, and you take all these hormones, and if you feel awful, I could deal with all the physical side of it. And the medication, the repeated disappointment and the waiting. So IVF is all about waiting. So you're waiting to start treatment, and then you're waiting for your period to start. So you can start taking the medication. And then you are waiting to have your first scan to the expo and then the next scan, and then you're waiting, or did they get any eggs? And then you're waiting? Did they fertilise and then it's did they make it to day five, and then you know, you transfer then you wait and take the practice test for two weeks. So everything's about waiting to have any delays is actually really heartbreaking. So obviously COVID-19 It feels very selfish to say this because lots of lots of people died or can be very ill. But that was quite devastating to me because of the IVF treatment. My wedding also got delayed. But you know, that was quite heartbreaking too. But the you know, the weight of the IVF and not knowing when it's good to start again with so hard. Yeah. And then again, so this is a never wait. And also what's really hard as you know, we have been an NHS waiting list is you never know how long so they just say to you, it's going to be a year, but you'll have the surgery in one year. It's a long time but you know what's gonna happen but it's the not knowing and the indeterminate waiting that I found really hard and everyone's always asking you questions, so I felt like every time as well. It wasn't my own disappointment in my husband. It's like do Telling your family about each. And I felt like I had to sort of say it's okay and reassuring them and telling them, they can try to make them feel better, shall we say, rather than making myself feel better? Does that make sense when you're trying to be there for people? Like me, I felt like I was managing other people's disappointment a lot. So yeah, so anyway, so on the waiting list. And all this time, by the way, I've been very proactive, I've had to be anyone listening to had interview traits, it takes a long time to get diagnosed. So I've had years of experience of being quite belligerent, polite, but village, when you talk to doctors chasing test results, requesting things I did call a hospital, and asked, you know, if they had any sort of idea about how long the waiting list would be, and it turns out, they didn't have my referral letter, it'd be lost in the system.

Emma Pickett  20:45

Thank God, thank goodness you are caught you a woman who calls thank God, and you imagine if that had been like six or seven months, exactly.

Katie Comer  20:53

So it could just been forever, and I didn't hear anything. So I called they'd lost a letter. So what they wanted me to do is go back to the clinic and get them to send another letter. And what I actually did, is gonna dog what my husband and our subset, and we had this conversation with a walk, and I remember exactly where we were. And he said, It's like you've given up, because I just felt so defeated, in that I just went in on myself. And I said, I can't do this, I said, I really want to see how much it cost to have the surgery done privately. I can't do this waiting list. And there's a waiting list. And so I did some research that found out that the best surgeons, and I don't know if I can name hospitals, but ended up at the Portland Hospital in London, very expensive, famous, 

Emma Pickett  21:40

not renowned for giving bargains. But that's what you needed to do. 

Katie Comer  21:44

This particular surgeon was and it was all very easy. When it's private, by the way, a phone number contacts, this was his secretary who picked up the phone, that wouldn't have happened to him. And she arranged a consultation, then they gave me a quote for the surgery. And because of the nature of the surgery, it has to be a particular time in a month. And they literally just said, Call us when you get your next period. And then if it gets like between day 10 and 18. So like you can't you have day one of your period, and they block you in?

Emma Pickett  22:10

Can I just ask a really dumb question. When you start going out to do things privately, does the NHS start treating you differently for other related things like so the NHS are okay with you doing that surgery privately and then going back to the NHS for the embryo transfer? That's not a problem? 

Katie Comer  22:25

Yes, because the I think the IVF treatment is considered a different, a different doctor, it's considered a different thing. The only thing that was slightly difficult was I had to get my IVF clinic, send the notes to the private hospital, where they'd shared them with NHS hospital, just automatically, it was a bit of a jump for a few red tape hoops to get my medical records for my consultant at the private hospitals to look at before he did the surgery. So that was the only thing that was slightly different. But that wasn't a problem there. Even though I was NHS funded, I technically was being treated by private clinics, I don't know if that helped, because you can choose where you have your treatment. And we went to that clinic, not because it was private, because that doctor was recommended to us by somebody else. So I've literally from the day I made the phone call, the first phone call to having the surgery was something like three and a half weeks. Wow. And it was only that long, because I didn't get my period for another week, it would have been sooner if I'd been different in my cycle. So that happened. And actually, when the surgeon did say that first surgeon, it nearly worked it, it basically just hadn't completely scarred over. So you just needed a little bit more. And this is the problem with this surgery, they remove your fallopian tubes, and now they're gone. But if you're relying on it, Scotland over, you know, so I had that, and then I needed to they recommended 12 weeks recovery before starting an embryo transfer. So at this point, I had four embryos left, they transferred to still didn't work. So in my view the next time so at this point, I've had seven different embryos transferred. And I actually remember saying to the doctors, like, is this still any hope? And he said, Yes, I still hope. And I think they're very good at being honest with you about honest but at least doctors actually that don't give false hope at all. So I said, okay, and he said, But what we'll do, we'll do some tests. So essentially, I had a dummy run, till I went through, I did all the hormonal patches and injections and everything I do to prepare for trans embryo transfer. But instead of doing the transfer, I went in on the day and they took a biopsy, from my womb, off my womb lining and testing that waste test. Not many clinics do this. I think what it is is it's a bit the the evidence for the value of doing it isn't that strong like that? There are some doctors who say it's but it's worth doing it and some doctors say doesn't make a difference. So it's not a standard treatment and because of that it wasn't funded by the NHS, I paid for these tests privately. And they came back saying everything's okay. So, that was interesting to the because what it is is they The testing to make sure that everything's ready in the womb. So it could be that they needed to transfer the embryo two days earlier or two days later. And at the time, it's weren't quite right. But it turned out everything was fine. And the only thing they came back with is they recommended I take a probiotic, not the one that you'll hear about in the news that you take orally for your guts. They wanted me to take a probiotic from a vagina, essentially, they said that could help. So I did that. So I decided to take that a few days before the next transfer. And my final transfer two embryos was the one that worked. So long journey. So I think the whole the whole journey from starting to try it naturally, to find out poking them was just over four years. 

Emma Pickett  25:45

Yeah, Gosh, gosh, that's just so much waiting. And so many letters, and so many phone calls, and so many conversations, and so many stages. And thank you so much for sharing, and I know there'll be people who go, Hang on this is nearly been half an hour, and we've haven't even bloody mentioned breastfeeding. But I think it's actually really important to hear the journey you went on. Because when we now come to talk about your breastfeeding, and, and why that matters so much. I think it really helps for people to know that all your story, rather than just Oh, yeah, Ava was IVF conceived. This is why breastfeeding mattered. So you had that constant struggle. And, and so many things were out of your control completely. And it was just you know, and again, it wasn't about medical faults, necessarily. It was just things not quite working out, or surgeries not quite working out, you know, or things that were no, under no one's control. But Crikey. I mean, do you remember, tell us what it feels like to have someone say, positive pregnancy test? Everything looks like it's going well? 

Katie Comer  26:38

Well, actually. So this clinic gave me a home pregnancy test to do. So they tell you which date to do it. And they're very strict about don't test beforehand. And I think reading forums online, I'm the only woman who doesn't test beforehand. I think everyone will

Emma Pickett  26:50

Or Phoebe in Friends I think did it about six hours after

Katie Comer  26:55

the day, because what they want to do is like, make sure if you are pregnant, it's a good strong positive test. I probably would have shown up positive a few days before. But anyway, I did wait to the day. And they tell you to use your first week of the day, first morning urine. Except I'm somebody likes to work a lot in the night I woke up at like 5am absolutely desperate. And I was like, are scared to go to the toilet because I didn't want to do the test I was when I started IVF I was excited to do the test. By this time. This is my sixth transfer, I was scared to do the test, I actually felt sick with nerves. So I lay in bed, crossing my legs, trying not to wet myself thinking I don't want to go anywhere, it got to the point where I had to go and drag my husband with me. And at this point, we're living in a military quarter as well, which tiny little we squeezed into this tiny little bathroom. And we did the test. And it just came up positive. Like immediately, there was no delay waiting for it. We meant to wait for two minutes. And it just was really clear line. And we both just looked at it and just went like in disbelief. And I was like it's coming up positive. And I didn't believe it. So I made my husband go and get two more thank t tests out there. And we did two more tests. And we had like three different brands of tests and did them all came up positive. And then we were just absolute shock and just obviously really happy. But to know, it doesn't really feel like it's happening to you like it's it's like a bit of an out of body experience. Really, because my husband, if you spoke to him, he would tell you he didn't think he was going to work at this point. He probably would have given up. He carried on with the IVF for me, because I wanted to keep going. Okay, he didn't see that anything was gonna change. So he just was he was out there ready to comfort me. And yeah, and remember, we just got back into bed. But we like couldn't sleep. We just sort of sat there and just relax, read watch something on Netflix. We didn't know what to do with ourselves. It was it was so strange. And he went to go make us both a cup of tea decaf for me, you know, and all this allotment. Because we didn't have to wait for the clinic. And they didn't want to tell anyone until we caught to the clinic because it didn't feel real until we called them ATM when the clinic opened. So yeah, it didn't really feel real. And then I had that thing, which I'm sure a lot of women who have especially if they've gone through treatment where I then had one day of euphoria, and then 12 weeks of being terrified that was going to have miscarriage.

Emma Pickett  29:25

Yeah, I can I can definitely imagine how that must feel. I mean, obviously I haven't been in your shoes, but I can certainly empathise that so. So what the wonder of euphoria, your your your body or your brain allowed that and then and then after that the balance just went into the nerves or other than that.

Katie Comer  29:41

Yeah, exactly. Or what if it goes wrong? So we have quite early scans, we've IVF you have to scan you're only about six weeks pregnant. And that's a check that the embryos implanted in the correct place. I think you're slightly more at risk of ectopic pregnancy with IVF. They call it a viability scan, which Think he's a bit of a I'd like to be named that but anyway that's what they call it. So and also they put two embryos and they wanted to see those one or two embryos still there so it was a singleton pregnancy but they had a good old check that embryo to hadn't ended up in my fallopian tube or something. Okay, so I had scanned at six weeks I had and then I paid privately for scans at eight weeks and 10 weeks I was so scared because I even I was getting all the symptoms I was having morning sickness and all that it food aversions as all the classic symptoms. I didn't really believe I was pregnant. So I was constantly wanted this confirmation that I was pregnant, still pregnant.

Emma Pickett  30:37

And did that. And that did that feeling mean that it was hard to imagine life with baby? Do you think that affected things like your antenatal preparation? Or did or later on in the pregnancy? Did you get to that mental space where you could start making plans,

Katie Comer  30:50

I think once. Now once we got past the 12 week scan, I started to relax a little bit more. But what was really important for me actually was having a gender scan to find out because that made it more real for me to imagine a little boy a little girl, rather than some as No, it made it easier for me to imagine her when she was born. And then as I got further pensee My anxiety did get better. But I'd still have these nightmares about IVF and not being pregnant and have a negative test. And I'd wake up and have to remind myself that I was pregnant. It was really strange. But yeah, I forgot forever long when I start to feel a kick and that kind of thing. I did relax a bit. Obviously. I had all the anxieties you normally do in pregnancy, you want to think to be okay, and you weren't me. But once I got past the first 12 Weeks was a lot better. And I did do an NCT course. And that helped me prepare some terms of breastfeeding, finally getting on to that so birth

Emma Pickett  31:44

before you talk about breastfeed, because, you know, we still were breastfeeding, but I'm just curious how it feels to do an NCT course, absolutely knowing that a planned C section is going to happen. So to go into that environment, which historically, you know, has sometimes been criticised for not necessarily putting a lot of emphasis on C sections, although I think the NCT would say they're doing a lot better with that. Now, did you find Did you find it difficult to attend some classes or not want to? Or how did the teacher kind of talk to you about your C section? Or how did you feel in that environment? And absolutely knowing you will be having a C section?

Katie Comer  32:14

I don't you mean, there's definitely sessions that I didn't feel so relevant, but I did attend all of them. And actually, the leader was great. And we had a whole section on C sections. Because, you know, there were seven couples in my Entity Group and three of us ended up having C sections, only the only one that was planned. So it might happen even if you don't plan for one. So those are they were really good at talking. No, I don't feel like if I was very honest, that begin and said medically and events have been breached. So she would have made a C section anyway, even without that. So I found that actually not a problem at all, though I'm really good. Glad to hear that.

Emma Pickett  33:00

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. 

Emma Pickett  33:46

So let's talk about breastfeeding. What were you thinking about breastfeeding during your pregnancy? And did you have any sort of prior conceptions about breastfeeding or any family experience around breastfeeding?

Katie Comer  33:54

So I grew up, I'm the eldest child, and I grew up not really witnessed any breastfeeding. I know my mom did breastfeed my siblings a little bit at the beginning. But I do remember lots of bottle feeding. So I think maybe he she did. Unfortunate my mom was no longer with us. So I can't ask her. And I know I do. Remember, she definitely breastfed one of my siblings because I remember her stopping because we were coming in out all the time with our friends. And she felt too self conscious, which I thought was a shame. So I didn't really grow up with that. But my, in my peer group, a few of my friends were breastfeeding. And none of them had had any problems. They were very lucky. So I naively I wanted to breastfeed and I naively thought that was enough. Just a will alone wasn't enough.

Emma Pickett  34:43

Well, you know, you say when I kind of like like, bananas to think this tone of voice, but it's actually something to be said for going in with the positive framework. I mean, there's a balance isn't there between wanting to you know, get the accurate information and get the right support, but actually, to be so I'd rather you tell me you're surrounded by positive breastfeeding experiences, then you told me, I was surrounded by disasters. So I went in expecting it not to. I'm not sure we can say that would have necessarily been better. 

Katie Comer  35:08

Yeah, well, it's a bit of both. So I'd had some friends where everything was fine, like baby lat straightaway. And the thing was, okay, I had a couple of friends were in their word, they didn't have a good milk supply. And they ended up donating, their Combi fed and then ended up bottle feeding, because I now realise maybe it was they needed some more breastfeeding support, potentially, I don't know, I didn't require too much on it. But and this, this was where one of my misconceptions came that if a baby ever goes near a bottle, they won't be able to breastfeed afterwards. It was almost like once you have that bottle, they won't want the breast. And that's what I believed, which was relevant later. But now remembering the entity class, the, the leader was actually a lactation consultant herself as well. So we had a whole session on breastfeeding. And a lot of it was just like, be able to recognise when the baby swallow in and like how a feed goes, and, and all that kind of stuff. And I remember asking all of us what our plans were, and everyone wanted to breastfeed, and I know that all of us managed it, which is a shame. But it just shows I think, majority women, in my experience intend to breastfeed.

Emma Pickett  36:17

Yeah, that is definitely the what the UK statistics tell us. We've got a really high initiation rate for sure.

Katie Comer  36:22

We all said something like, I'd like to breastfeed for six months or a year. We didn't have a long date on it. I naively thought I want to breastfeed so are breastfeed, and I didn't really, I wish looking back, I didn't a lot more research, a lot of things I've read since haven't Eva, I think, Oh, I wish I'd known this before she was born. So I didn't really read much about what to do if it doesn't happen straight away, or if there are difficulties at the beginning and what you can do about that, when I had Ava does a few things that potentially made things more difficult for me. So as discussed, she was C section baby. She also was a late preterm, which is born at six plus four. 

Emma Pickett  37:05

Okay, gosh, yeah, that's, that is a challenge that a lot of people don't realise. And I did an episode with Catherine Stagg about what she calls the great pretent great Pretenders, that definitely can make things a bit more challenging. So you had a few things up against you, didn't you? 

Katie Comer  37:19

Yes. And also for five days before I had Ava I was in hospital, because I was had severe vomiting. And she was basically squashing me is what it was, we were both squashing each other probably because of all my scarring. And she was quite big baby. I was literally vomiting bile, and like they brought me in this hospital and I was on the maternity ward, I'd been looked after. So I'd had five days of basically not eating anything and not sleeping. And they just had me on painkillers and like anti sickness medication. And then my waters broke at 2am When I was in hospital when they ended up so my section was planned, but it was sort of a little bit of emergency C section because it wasn't the day they were planning to do it at all. So they had to get the surgeon in. And the the specialist surgeons in the room, but luckily, they sort of had everyone on, like on standby because they knew I was in hospital. And if things happen, they wanted the right people there. So I was really well looked after for the but the you know, a couple of things happen to the spinal block didn't work. They just didn't work on me. I could feel everything still. So they gave me an epidural as well. Okay, Pam, for the C section. But I it's my belief that was a bit of a weakened state because of this. Obviously, I was on a drip and everything but I wasn't really in a great shape when I had when Dave was born. And then she came back early, and I didn't lose excessive amounts of blood during the C section, but you do lose low blood with C section in a natural birth. So the end remember then tell me are you You lost I can't remember how much but I remember them saying but you don't need a blood transfer. A transfusion so you don't need a blood transfusion. But I ended up having to take i in tablets things because I was quite anaemic afterwards. So that you know those few things happened. So she was born. And she was also quite squashed. So she had cuz she was breech s Her head was squashed, which I think she's squashing it's my ribs. And I later found out she had a bit of a squash mouth and a high, like a high palate or a small palette. This was about two weeks later, I found this out. But at the time, I didn't know this, but I knew she was a bit squashed.

Emma Pickett  39:28

Can I just say that none of your reading could have prepared you for this. And you say I was naive and I went into breastfeeding without knowing everything. I don't think you're going to find the chapter on squashed faces when they haven't reached so well. Maybe. Though, I don't think your lack of preparation in inverted commas is is causing any of these, these barriers to getting breastfeeding to a good start. There's a lot going on here. 

Katie Comer  39:50

Yes. And well. The main thing really was i She wouldn't latch so. It wasn't immediate skin to skin. But within a few minutes I had to get Skin quite soon after the birth. I remember the midwife saying we'd like to use skin to skin, yes, please put them on my chest. And I remember doing the head bobbing things I remember from entity class, I showed videos of the woodpecker in you know, so she was immediately trying to find my breast and had those instincts, you know, I think was good there. But she just couldn't, I couldn't get her to latch. And what was really tricky, it just had a C section. And I had, you know, needles, wires going into me on my arms, and people checking me in a kit, like lifting my arm up to check my blood pressure or to do an eye. So I was, I couldn't really have that time to relax and try and get her to latch. And I remember saying, Oh, can I have someone to help me trying to teach breastfeeding? And they said, Oh, yeah, when you get here, so when we can help you. But I remember her trying and thinking, Oh, that's good. That's a good time. You know, she got that instinct. They're just trying to do it. And remember, it's holding her there. And just trying to remember what they said, an entity about like nipple to nose and all this business. And it just wasn't happening. But I was just like, again, the euphoria of just having a baby. I was just I wasn't that bothered about at the time, I felt like, oh, okay, you know, parents being you knows all sorts of things happening. And I remember just kept asking everyone who came in, because someone helped me get to latterly I can't get her to latch and just nobody. I just was popped off a lot. Like, they put me in a private room because of the issues I had before. People kept coming in to want to check me in tech, the baby, but the no one would want to help with this. And I guess I didn't really understand, like, the timeframe to feed her. So I wasn't too worried because I thought, you know, she's only not very old, like, maybe that's fine. And then we had a really terrifying moment where she appeared to stop breathing. So I had her snuggled next to me. And she just went very still in purple. And my husband just grabbed her and pointed her to a nurse, they hit the emergency button. And the moment he handed over, she's cried. So I knew she was okay. But it was almost like, she got a bit floppy and can't really explain it. And they had a doctor check it over. And they said, Oh, yeah, she's a bit floppy. Don't punish didn't react at all when they put a condom in her that didn't cry or anything. And they they said, Oh, she might, it might be that she has an infection. We're gonna give her antibiotics. Okay, so that happened. So that was terrifying, because I felt like I had smothered her but I don't know what happened. And they said, babies do that sometimes. Yeah, just kind of always actually held her breath or something that she was quite a bit blue and purple. So then I was scared. I'm a bit scared to breastfeed. Anyway, so it was about five hours after she was born. And I said, a midwife came in. I said, she still hasn't latched can have somebody help me. And she said, Oh, she hasn't eaten anything yet. And I said, No. And that made me feel like the most negligent parent that ever existed. Because I hadn't fed her. But I'm talking about I must have asked every half an hour. Can somebody help me? Yeah. And there was no help offered. And they said, What do you have any formula to give her? And I did, because I was so worried. So in my hospital bag, I had, you know, there's little pre made bottles, because I was worried that something could go wrong during the C section. And my husband might be left with a baby for several hours without me there and had need to have something to give her. So they were like my backup. They did then get somebody eventually to come and show me how to handle Express but I wasn't really getting any colostrum. I'd also intended to harvest colostrum antenatally but I didn't. I was told to wait four to seven weeks. I never got to bed seven weeks. So that didn't happen. So they sort of showed me that but they didn't. And they said oh, you've got quite flat nipples. That's you have a comment they made? You've got quite flat nipples. But they didn't. There was no help. It was just like, oh, okay, didn't you need to feed her but the way they spoke to me about oh, she hasn't eaten anything yet. And I resent scared I gave her formula because I thought, oh, no, I've like, damaged my baby. I'm in that situation. Yeah. And then someone was a bit kinder. And they did say, oh, it could be if she has some formula, a blood sugar be better and she might have more energy and she then might be more likely to breastfeed is what they told me, which may or may not be true. So her blood sugar's a bit higher. She'd be more weight because she was quite sleepy. And then I got moved to the main postnatal ward from this room. Oh, and during this time, don't quote me anything to eat. I've had to ask for something, 

Emma Pickett  44:32

my goodness, you haven't eaten anything for like a week.

Katie Comer  44:36

I've been kept alive on a drip. So I had to say please, because I think I was having my C section when they come on, take the food orders or something. Anyway, so I had so pleased to have some food. So they bought me a sandwich or something that my husband had to leave. So the hospital's policy was no visitors between 9pm and 9am. And so my husband had to leave at 9pm and I was then In the stall, Miss Ward, and all night, again, I just kept asking for help. And so many people to sit with me to fire people come and sit me. After 10 minutes, they'll just be like, Oh, almost like it's not happening. Like, they weren't really people who are trained to support breastfeeding, shall we say?

Emma Pickett  45:18

So you're bringing over to the breast and she's just not latching at all. She is she sort of zonked out? Not even trying? Or is she bobbing and drying what was happening?

Katie Comer  45:26

At this point, she was even trying so that the initial bobbin happened when she was first born. But she wasn't. She was just crying, because she was hungry. So I then was given it the bottle, because also it's like, free. You want to ward with five of women with babies crying, and you just think she's crying, and I need to feed her. So I would every time I would try and breastfeed, it wouldn't happen. They would say to me or call when she wakes up, and we're trying to help her latch, but then they would take so long to come to me when I called the button cause because it was so busy. I'm not there's no personal blame here like these individual.

Emma Pickett  45:59

How about visual people? It's not about those individual women, it's about system that leaves you in this state. 

Katie Comer  46:05

They were too busy. Because they had all these other jobs they had to do like looking after these women and every single person who came to me I'd asked, Can you help me that you know, the baby doctor, the nurse who came to take the baby, the nurse that came to check me that none of them were like, you know, lactation professionals. I just can you help me? Can you help me? I was so desperate for help. Anyways, I didn't have any sleep at all that night at all. Not didn't when people say Oh, I didn't sleep. And they mean, I didn't get very much sleep. I literally didn't close my eyes to sleep all night. So I was in quite a state by the morning. Next morning. There were more people around. And there was, I don't know, there were lactation consultant, but there was a lady whose job was to help with breastfeeding questions and queries. So I don't know if there's a volunteer support work. I didn't know her job title, but she was going round and helping people who want to support breastfeeding. So that was the first time I got good advice, I would say so she helped me try different positions, like sideline and divide behold, we didn't achieve a latch she did say about my nipples being quite flat. She then got me just the first time so I'm what we're pumped, she got me a pump. I said you can use that. It could it might help roll out your nipples. She showed my husband how to pace bottle feed in the meantime. And she sort of in she bought she got me some some injuries so that if I got any colostrum, I could try and give her that for a syringe. So then I'd have 15 minutes with her like there's quite a lot covered. But that was the last time I saw her and just no further help. So what I managed to do, I might I worked out, I wasn't very good at hand expressing or hand for the costume. But I worked out of ideas to pump. I could get some colostrum. So I was getting tiny bits and given that to her when I could. And someone at this point, this is the first time I'd had mentioned nipple shield because I said about my nipples. But then they did say it's not very good with into your milk comes in because obviously it's teeth. Colostrum is too thick. And everyone heard about nipple shield before. I've not heard of any other kinds of feed in like copper spoon or not heard of any of this stuff. So I didn't try anything other than the bottle feeding in a little bit of squinting colostrum. The one thing I did do is get my husband to order me a breast pump from an artist charged hospital. So I two nights in hospital. And then I was discharged and again the first night just doing the same thing. formula feeding her but trying to give her little bits of colostrum that I managed to collect the day the next day. So my first morning at home, it's when I woke up with that classic feel like I've got two rocks in my bar sort of Milka transitioned. That day, I was like, brilliant when the restaurant provides the posts, I'll be able to maybe express milk. But then I had another barrier. So it's such a long story. 

Emma Pickett  48:53

Okay, this is your life. This is your life. And if if it's just you and me at this point, and we've lost everyone else, I don't care because I'm very much grateful that you're sharing your story. 

Katie Comer  49:02

So I had another barrier which was I was supposed to have the midwife come to the house that day, you know, the day after you come home, you have to commit to it right? But my say because of my anatomy, they did my C section incision vertically rather than horizontal. That is typical. And because of that, I believe my banded, it looked like my wound was leaking. So I sent a photograph of it to my community midwife, saying, I don't know if I need another dress in here. And she looked at the photo and said, You need to go to the hospital. So I didn't have my midwife tech at home. I went to the hospital for them to check me out and they said why are there? Well, she said I'll arrange for a midwife to check either to do her checks. So I then had a missed opportunity to have maybe some breastfeeding support from her or advice from her. And then I was separated from Ava so I was taken to waiting around for ages so on To get some wound care specialist to come and look, because they weren't really sure what to do. And the whole time, I was just really distraught because I was thinking, I should be trying to pump it up doing something, I felt this pressure that I knew I had this window where Katie was, so my husband has hurt, okay, you taken a different route, the hospitals had to be checked. And then he comes and brings it back to me. So I was like, in the hospital, and I couldn't, again, was in the same situation, I didn't have the pump, I couldn't do anything. I didn't keep a formula. And then so a few hours later, discharge, sent home, got home, the pump is there. But also my in laws are there because they've been looking at our dog for us, and they brought the dog back, but they want to see the baby obviously, as well. So I remember having to say, I'm sorry, I just need to go upstairs and work out his breast. Metal, my sister in law with me who was like one of my best friends, he's someone I'm comfortable seeing my breasts. And we're printers, we worked out how to use this breast pump, and I got milk. And it was his best feeling ever. When I got this milk came out, and I feel the pump. And I put the milk in a bottle and I gave it to a lady. And it was like, very brilliant. So at that point, I was like, at least if I never get her to latch, I can give her my milk. Right? So I was then it was safe basically got to a point where about 55th By about day five after she was born. I was given half four and a half breast milk at that point. I wasn't pumping enough. I hated pumping, by the way hated it. But I was getting enough about half her feet. 

Emma Pickett  51:35

And still and Ava's still not attaching at this point, still not actually.

Katie Comer  51:41

And then I had another midwife checkup, you know, you have a couple and went for that checkup. She asked about how we're feeding her and I was explaining. Then she said, she gave me a phone number and said, you know, you can get breastfeed and support. Up until she's a certain age, I won't say 28 days or something the hospital would give breastfeeding support. Here's a phone number, but the clinics only on Mondays and Thursdays, something like that this is Friday. And okay, and then she took my blood pressure, my blood pressure was through the roof. And then she made me go back into the hospital to be checked. So I then had another day in the hospital. Again, my pump is at home and left at home didn't think I need it for midwife check. I remember being extremely distraught in the hospital. Obviously, you have all the flow or the hormones into this mix. I was having all the postnatal hormones. And I remember clearly just been so distraught, I remember in my head or became about breastfeeding. So all of these hormones, was this desperation to breastfeed and, you know, linking back to the beginning of what we're talking about. I felt like, this is the thing I could my body could do right for me, like I had assisted conception had unassisted birth, I didn't do any of that. My body didn't do what you're supposed to do then. And although it's ridiculous, when you can't get pregnant, or do you feel like you're not a proper woman or less of a woman. And then these things are things you tell yourself. So to my mind, it's like I just want to distinct this to work. And it was really important for me, for it to work. So I'm getting more and more present in distress, my blood pressure is going up and up and the doctors are just like, you just need to calm down, then telling people to calm down never works.

Emma Pickett  53:21

Get me a breast pump. I'm gonna come down.

Katie Comer  53:24

I don't know why I didn't ask what I asked for breast pump

Emma Pickett  53:27

Well, enough on your plate. I think someone else should have said, postnatal mother doesn't have a breast pump. 

Katie Comer  53:32

And I do a very kind midwife did speak to me. And she said, you know, she's still getting, if you're giving us some of your milk, just like she's still getting all that wonderful stuff. She said she's still getting all you know, even if you have to exclusively pump it's you're still getting everything from you know, and she was really kind to me about it. But other than that, they just wanted to I think they would have had preeclampsia, but having said that, you know, they kept making me give you examples, eventually got my blood pressure down and went home. And then I had a bit of a bit of a mental struggle, shall we say? Like my husband did say do I need to be worried? It's just postnatal depression at one point he did say He's like, he's never been happier. We've got this healthy baby. And I'm so preoccupied all the time because all my mind was occupied by I should be pumping I should be doing this I should be doing this should be should be should be. And I hated pumping. I felt like it's separating me from her. I felt like when I was pumping, I couldn't hold her. And it was also exhausting because it was like I had all the bottle cleaning and sterilising and the freedom to do and then the pumping as well. It was like Wi Fi like double the work to me. Any listeners who exclusively Express and breastfeed that way just have an extra step because that is so hard to do with that And then I did call that number and they went Ava was 10 days old I saw, I think, for the first time ever saw somebody who was really qualified to help with breastfeeding support. And they put a gloved hand into Ava's mouth, and they checked her mouth and told me that, you know, she's got a small palate and this and they, but she was, she did have like, what they called a 50% tongue tie. But they said, it wasn't affecting her ability to suck on the finger. Like that was fine. She didn't need a snipping. And they just said, I think you just need to use nipple shield. And they gave me a nipple shield. And she latched see attached first ever time. 

Emma Pickett  55:40

How did that feel? Do you remember that moment?

Katie Comer  55:43

I remember just being like, what is this miracle we didn't know. It just it felt great. She didn't do a for feed like she, she did struggle a little bit. But she kept coming off and back on and off and back on. But I actually, for the first time she swallowing into the office, while I'm him, she got some milk he swallowed. And they sort of taught me how to use a shield and sent me home and said, This is first day they said, practice. Practice, we'll see again on Monday said practice over the weekend and come back to us. And then again, I was practice hard. Use a shield, she would feed a little bit but she did struggle she kept coming off and ended up then using the bottle to give her breast milk or whatever had formula didn't have enough personal says at this point, I still can't be feeding formula and my milk. My back on the Monday. And we had another an even more experienced, you know, when someone walks in the room and the office defer to them. So I was like, this is the person who knows. And she can remember them saying, Oh, this could be good short, short term solution. And this lady said, Oh, it can be long term. That's fine. She said,

Emma Pickett  56:52

Yeah, I think and I'm actually really glad that you're talking about nipple shields, because there's so much negativity around them. And in fact, those of us who are lactation consultants, we have those stories in our mind of the people who did not attach until a shield came along. And and it absolutely transformed their experiences of breastfeeding. And it just got you on the path of breastfeeding. Exactly. And lots of negativity or NFL shields are based on older research when nipple shields were much more fit, you know, thicker and made from a different kind of plastic and this flex flip less flexible, I think, modern shields that are sized correctly and used well. I think it can be an absolute godsend. And I'm glad she said that because I think if someone gives you a shield and says, This is wrong, you shouldn't really be doing this. But let's cheat for a little while, with the aim of getting rid of it as soon as we possibly can. How's that going to help your oxytocin and help you breastfeeding? 

Katie Comer  57:41

And that is exactly the first time I was given this shield it was it was similar to that it was like, you can use this until you don't need it. And the idea was, I definitely strongly got the feeling of don't let her rely on it. 

Emma Pickett  57:56

Because you will do that. Have a chat with Eva sit her down and say

Katie Comer  58:00

yeah, and then. So for this more experienced ladies who say it can be a long term solution, if this is how you This is how you breastfeed the whole journey. That's fine. Essentially, it's what she said. And in that session, I She did a four feed with a shield on and it felt really good. And yeah, and then from them, the one thing I would say is to are still competing for while I in total 16 weeks, she was still getting a bottle at least once a day. And I think that was because a bit of lack of competence at this point, as it was really didn't like the confidence she was gonna get enough for me. And also her feet are really, really long. And I didn't know if the shield was causing a milk transfer issue or something I don't know. Maybe she just had long feed. Who knows. But at this point, it's my my husband, we used to help him me, he was used to doing some of the feeds and it we had this routine. And it was quite hard to wean ourselves off the convenience. I guess I'm a bottle occasionally. But I do remember from the for the last sort of, for about 10 weeks onwards, you'd pick was having one bottle of formula a day and the rest of the time she was breastfeeding. And then about 16 weeks I just said that's it. I think I've been confident I'm making enough milk now just getting enough for me. And there was a lot of cluster feeding in the meantime, which was interesting because again, I wasn't really didn't really know what cluster feeding was. And I had a lot of relatives who nevertheless fed say an auto feeding again and and not in a in a concern for me. Why not? And then, you know, stop, stop doing it sort of way but they were surprised how often should you feed in because they were not used to pay for breastfed babies, I'm guessing. And that made me a bit worried. So I think I it was like an emotional crutch for me this bottle that I could give her something.

Emma Pickett  59:41

Lots of people talk about hanging onto that last bottle much more for emotional reasons. 

Katie Comer  59:46

And I think for the first few weeks of exclusive breastfeeding I think I always had somewhere my nappy bag or bottle pre made formula just in case you've never didn't need it. And then yeah, but from then it was breastfeed in all the way. And still with a shield, and we use a shield until she was seven months. And one day, I just wasn't quick enough getting the shield on. And she just touched and I was like, oh, okay, we don't need that anymore. And again, I carried a shield around me for ages. Not using it, but I just had it with me just in case. 

Emma Pickett  1:00:26

So literally, it was like that one day, no shields, she just yeah, she just happened to make it work. And you you'd never used to just

Katie Comer  1:00:32

get after that, I guess bigger and more competent. 

Emma Pickett  1:00:36

That palette had changed shape as well. So that high palate had been affected at the beginning. Maybe as her palate dropped as her face widened, it made it easier for her to get that nipple contact. Great. So So you hadn't felt any pressure to remove the shield before then you hadn't been trying without it. You hadn't been worrying about it, you just embraced it, because you had that message that it was okay. 

Katie Comer  1:00:55

I tried a few times not because of the message or anything. Although there was a little bit of female wasn't properly breastfeeding, because I used it so hard that my mind a bit hard on myself, I think, mainly, I just found it real fast. And it made things like breastfeeding in public was made a bit more tricky, because it's really fiddly, because you've got a baby that's crying and you're trying to unhook your bra. And then you're trying to get if it has someone to help, what I do is I pass it to somebody and say, hold her, I'd get the shield on and then get them to pass it over. I found that real fast. And I didn't it just felt like a bit of hassle, really. So I was trying the classic thing of start with a shield, then remove it and see if we carry on and she just, it never worked. And then just one day it works you just attached. And I do wonder how long she probably could have done that. And wasn't because I just automatically gave her the shield.

Emma Pickett  1:01:45

And you mentioned the beginning your husband had been worried about your mental state. Do you mind me asking did that carry on being a concern for for either of you? Or did things get you to go into a groove? 

Katie Comer  1:01:58

Now, a few days later, things were better once she was sort of feeding with the shield and we've gotten to add kind of accepted this what's happening now we're complicated analyses in the field. I do believe it was just Massey that that hormonal situation you're in after you give birth where it's like the worst PMT of your life. And everything just built up in my head. And I had lots of really lovely well meaning people around me but probably saying not very helpful things like it's okay to formula feed. I formula fed my baby was never okay. Or you were formula fed new. Okay. Lots of like, you need to think about yourself. Like they're really concerned about me. And they fought reassure me that formula was okay. But if you really want to breastfeed, that's not what you really want want to hear. Because at no point did I say that formula wasn't okay. I've been using it. I think that it's a great resource tool for, you know, for babies that for whatever reason can't receive human milk. It's just I really wanted to give her my milk and have to, I don't believe that formula has the benefits of breast milk doesn't I wanted the benefits of breast milk, rather than thinking formula as a devil? You know, I mean, it was that was my feeling. But I felt like my determination to breastfeed, made people feel like, that's how I felt and they wanted to be sure me, Does that makes sense? Like, 

Emma Pickett  1:03:19

yeah, I think you're right, people make assumptions. And there's a lot of projection isn't there from their own experiencing so and somebody who says I really care about my breastfeeding, implicitly, is therefore criticising a different choice. That's, that's the sort of jump people make, or as you say that that's not what you meant to do at all.

Katie Comer  1:03:35

I've definitely an experience as well, from other women where, let's say, I'm at a class, and I'm breastfeeding either. And if there's a woman who isn't someone who's breastfeeding, they always feel like they have to have this explanation about why they're given a bottle. And I tried to breastfeed, but it didn't work, because it's happened and I get like a confessional from them. And at no point have I, all I've done is breastfeed in front of them. And they there's an assumed, like, they need to justify to me why they're not breastfeeding, which I found really interesting. Because I've No, I've never been one to judge any one for how they feed their baby whatsoever. And seem judgement is there, which is interesting. 

Emma Pickett  1:04:15

And I think we've probably, you know, for that person, they probably have had moments of feeling judged. I mean, it's a very complicated story, isn't it as to why somebody doesn't breastfeed? And I know lots of people do say to me that when they do formula feeding, especially a young baby in public, they feel very uncomfortable. And then we get people who say they feel very uncomfortable breastfeeding, so nobody seems to be winning at the moment in the in this story. But yeah, I mean, that can as a lactation consultant, I get the confessional a lot. And there's a lot of people who've got a baggage that's been unprocessed and a new trauma, grief and trauma and refer people to Amy Brown's book on breastfeeding, grief and trauma. But you are not one of those people. You were breastfeeding. Eva happily at seven months and now you're still breastfeeding at 14 months. What steady, lifelike breastfeeding right now.

Katie Comer  1:05:04

Last month or so she has really increased the amount of feeding, respiratory wants to do. I don't know if it's developmental around 12 months, because obviously we have like solids here from six months. She was literally just wanting to feed in her naps, feeds asleep for naps, and bedtime, and then she would wake up overnight wanting feeding. But between that she was okay. But now, the last month she has suddenly increase the number time she's asking me. And when I say ask him, she's 14 months. So I mean, she pulls my jump and wind and I know what she means. But that that is asking that wasn't Yeah, it doesn't say please can have some milk mother.

Emma Pickett  1:05:46

I do sometimes find that breastfeeding does increase purely because of the joy of asking at this point that it's you know, when you especially if you're not doing a lot of talking where everyone else can understand what you're saying. That's the one bit of communication that really works. And it's the in you really get that need met? And that can feel amazing in a pairing. What are your plans for breastfeeding over? You're just going to see how it goes? Or what do you have any goals in mind?

Katie Comer  1:06:07

I don't have any goals at this point. My initial goal was to feed until she was 12 months, I think probably because of my mind, I thought because then I can give him cow's milk if needed instead of formula. It felt like a good goal. But obviously we're past that now. And we're, I'm happy with how things are I don't really have a plan. Everyone wants me to have a plan. Interesting. Oh, how long did it your feet for? I don't know. And I guess like as long as it's working for us, we'll continue. She does fees a lot overnight. And there's part of me that thinks maybe I need to strategies reduced overnight feeding. But then I don't know how to get back to sleep without feeding her. So that's, you know, it's a great tool, isn't it? Like she's back to sleep. And second when she wakes up at three o'clock in the morning. So long? Yeah. long way of saying I don't really have a plan.

Emma Pickett  1:07:04

Good for you to not have them. See how it goes. Everyone's so busy on what your goals tell me your goals, you know, two years, three years, whatever it is, you just have just, you know, your goals will vary from day to day, week to week, depending on how things are feeling. And you're in a good place now. And I know, we have talked about this. So I feel comfortable asking you this question. You've you don't have any plans to try and conceive again that that obviously that was a huge challenge last time. And that isn't something you're looking to do again, is that right? 

Katie Comer  1:07:29

That's  right, we we did discuss it. But I'm, I'm forced to now and I just I don't think I can go through go through IVF. Again, because there's this is the psychological aspect of it, rather than the physical. And also, because obviously, it took so long to have Ava so I remember the last few transfers. My goal went from I always for someone to two children, but my goal was just, I'll be so lucky if I have one baby. And when I found out I was pregnant with Ava, then I just pitched my life with one child. And I've came really happy and content with that vision of how my life was going to be I just felt extremely lucky. I have friends who've had IVF and didn't work. So I kind of accepted that and like happy acceptance of I'm gonna have one. And that's how I pitched in my life. So when we started discussing, do we go for a second, it was this big shift in my head of like, oh, I need to reconsider things. But you know, ultimately, we decided, you know, we're really happy. We're really lucky. With one. 

Emma Pickett  1:08:33

Yeah, well, you definitely sound like you have a very lovely little girl there for sure. Now, this is a impossible question to ask. So I will ask it at the end. You don't know what it's like to not have, you know, to not have an IVF baby and a baby with a sister conception. But you mentioned before that you you'd had some feelings that maybe your body hadn't worked and breastfeeding. That's why breastfeeding was extra special. Can you put that into words as to possibly how your conception of Ava made a difference to your feelings around your breastfeeding right now? It was breastfeeding meant to you do you think? 

Katie Comer  1:09:05

I think it's what's best for you to start working to me. It was in terms of like reproduction. Or like being a woman It was the first time it worked for me. Like it felt like it was working and doing what it's supposed to do. You know, after feeling like I was failing as a woman, and this is classic thing. I'd never say this to any woman who's struggling to conceive, but that's how I felt myself. I didn't, I felt like I was failing. And I felt quite ashamed about it actually. And so to have my body sort of do the something it's supposed to do as a woman like is really just a really nice feeling. And yeah, it just made me sort of, I don't know, like sort of forgive myself a bit for that. If that makes sense. Like I'll forgive my body for letting me down because it's not letting me down anymore. 

Emma Pickett  1:10:00

I know that I can understand that for sure. Thank you so much for sharing your story today, Katie, I'm really, really grateful and, and I know there'll be people who listen to this who maybe have found bits of it hard because it's reminded them of stages in their own journey and, and I'm sorry if that is the case for anybody. I'm also aware that some people will listen to the story with absolutely no experience at all of all fertility treatment. And I hope this has given them some insight into some of the challenges that people might face. And and Three cheers for nipple shields. Let's let's add that in as our postscript because I think it's important to recognise what a valuable role they can have in someone's breastfeeding journey. Is there anything we haven't talked about that you want to make sure we cover or anything you want to say to anyone who might be listening?

Katie Comer  1:10:43

If you are pregnant, or plan to become pregnant, and you'd like to breastfeed, definitely do some reading preparation. And don't just think, oh, it just happen. Because you might be lucky, and it might just happen for you. But yeah, I definitely would give that advice. And then, in terms of anyone who's, you know, on their IVF journey is just to like, Listen to yourself, like I had a long journey, and I had to be quite resilient. But I had to be resilient for myself, because other people wouldn't do it for me. And that sort of surprised me. Well, I had lots of people saying, it's okay to give up. You know, it's okay to stop. It's okay. You know, have you thought about a dropped in Have you thought about fostering trying to get me and I had thought about those things, but I, I didn't feel like it was time to stop the IVF. And you got to trust yourself with that, I think because if I had stopped when I was given that advice, I wouldn't have over. But equally, you know, when it's time to stop, and it's okay to stop as well. I think just trusting yourself, I think with that, like your own instincts around it.

Emma Pickett  1:11:59

Yeah, thank you, Katie. That's really helpful. Thank you very much for joining me today. Really, really grateful and good luck with the rest of your breastfeeding journey and I look forward to hearing how things go and whether you choose to do a little bit of nighttime boundaries or continue going with the flow. I hope that the rest of your journey brings you lots of joy and some more sleep as well.

Emma Pickett  1:12:23

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.