23 | Elyse
‘Are you feeding your baby?’ These are the words that confronted ICU nurse, Elyse, at a week postpartum when she was told that, despite her strict three-hour feeding regime, her newborn son was starving. In her words, the subsequent diagnosis of breast hyperplasia / insufficient glandular tissue (IGT) caused her world to come crashing down.
Elyse tried everything to increase her supply, but was left crying and pumping for over six hours a day while enviously watching the bond between Patrick and her husband blossom. Unfortunately, her mental health continued to deteriorate even after she stopped pushing herself to her absolute limits. From grief about her experience to bouts of rage, Elyse kept dreaming about running away.
That is until, finally, a nurse at a residential stay recognised that Elyse needed more support. The trajectory of her postpartum turned around because of this, and soon after, she even welcomed twins!
This is one woman’s breath-taking story about letting go: letting go of the pressure to breastfeed, letting go of pumping, letting go of recording every moment in a baby app, letting go of self-blame, letting go of resisting help, and letting go of control. This is Elyse’s story.
“My name's Elyse. I am an intensive care nurse. I'm married to Bohdan, and we had our first son at the end of 2019, and he is Patrick. He's now four years old. Then in September in '21, I had the twins, Madeline and Arthur. It's been a jam-packed four years. Then with COVID and everything else, it's been bit of an interesting postpartum journey, and it's definitely been eye-opening, that's for sure.”
“I was very, very lucky. I had a very smooth pregnancy and had a really lovely labour and birth. So from that point of view, I'm terribly, terribly fortunate, and I know that. I thought I was going to get away scot-free pretty much!”
“When you do your breastfeeding classes and you go to the hospital and they tell you that everyone can breastfeed and your body produces enough milk and no one had ever pieced together that my history of PCOS, my minimal breast changes throughout my pregnancy, would lead to a diagnosis of IGT [insufficient glandular tissue] for me.”
Upon taking Patrick home, a midwife came out to Elyse’s home to do a check. “One of her lines that she said to me - that has always stuck in my head - was, ‘Are you feeding him?’”
“I was like, ‘What?’ Here I am, I'm very organised, very controlling, anal-retentive ICU nurse! I've got an alarm set for every 3 hours. I am feeding this child every 3 hours, if not more, because this is what I was told to do, so this is what I'm going to do!”
Despite Elyse’s feeding routine, Patrick had lost over 10% of his body weight. “She started asking about my medical history and we got onto the fact that I've got PCOS. She was asking about breast changes and things like that. It was just very fortunate that she happened to be a lactation consultant as well. She had pieced together that it was highly likely that I had the IGT and she's like, ‘Your poor little newborn is starving! That's why he is staring off into space and that's why he's not sleeping and that's why he's got that zoned look on his face!’”
“I have lots of pictures of him as a newborn. Looking back, it's eye-opening to see that he was just lying there with his eyes open, staring off into space. To be told that your husband needs to run out now and get formula, sterilisers, bottles, it doesn't matter what type you can get, just get whatever you can get your hands on and just do it and do it now and feed this poor baby.”
“We were threatened with going into special care for monitoring and just to make sure that I was actually feeding him and that I wasn't neglecting my own baby, which I think was where her worry was stemming from. Hearing those words and that picture of that, I might not be able to breastfeed, really just broke me.”
“I felt like I had been lied to, which is a very odd thing because I don't think anyone lied to me. But just when you feel like you've been told one thing and then your world comes crashing down and all of a sudden the image you have of your postpartum, of breastfeeding and being able to chuck some nappies in a bag and go for a walk. You don't have to worry about bottles and sterilising and formula. All your friends breastfed till over a year, and everyone can do it. Why can't I do it? I'm broken and my body's broken and it just… I think I cried, I reckon, for a good six or eight weeks of my postpartum journey there.”
“We spent a lot of time going to breastfeeding clinics and doing everything we could to try and establish breastfeeding for me. Taking prescription medication for it, doing triple feeding. I was pumping maybe six hours a day or something like that, some ridiculous amount of hours, and getting maybe 100mls of breast milk combined. It was nothing. It was very pointless. It felt very pointless, even though I don't think it was. But just that pressure to succeed and just, nothing worked.”
“Props to anyone that can do supply line feeding because it is difficult and it just didn't work for us. I think it was six weeks or eight weeks postpartum, I decided to give that up.”
“I think saying to my husband that I couldn't do it anymore was probably one of the hardest things I've ever had to come to terms with or tell someone. The fact that no one gave me permission to give up, I just felt like everyone was like, ‘No, you can do it. It's fine, just keep doing it. Just keep pushing yourself to the absolute brink to try and get 100ml of breast milk into this baby a day’ - which wasn't even a full bottle! It wasn't even a full one of these feeds of six or eight feeds a day.”
“My husband was going back to work and I couldn't triple-feed solo, I couldn't manage it. I felt like I wasn't bonding with my baby. I felt like I was just there as a milk machine almost, just try and get any tiny drop I could out of myself, and it just was not working. It was hard.”
“The one thing I figured out that I could do while pumping was wash up the bottles. I would stand at the kitchen sink and my husband got to have all these beautiful cuddles with Patrick and they got to bond and I could see them bonding. Here I am, crying into the sink of bottles while I've literally got a pump on my chest.”
“It really isn't how it was meant to be or how I envisioned it, I guess, or what I got told it would be like either.”
While Elyse stopped pumping at about eight weeks postpartum, her mental health continued to deteriorate and she didn’t receive any emotional or mental support until 10 months postpartum.
“It was a big eight months too, because we had the bushfires at the end of 2019. We spent a lot of that time indoors anyway, because of the risk to newborns. Then we got to the beginning of 2020 and we started going out and I started to have a mother's group and we would do little play dates here and there, and then COVID hit. Then we all went into lockdowns.”
“Patrick would have been about six months old at the time when we went into lockdowns. So I think the whole lockdown situation, the fact that he wasn't sleeping well, he's never been a good eater or feeder, and I still, to this day, blame myself for that. I think I'm the root cause of all his feeding issues, which I probably know in my head that it's not, but that's how I feel, and that mother guilt is just, it plagues you. So spending that time basically trapped in an apartment with my husband and my son and my dog just felt like there was just no way out.”
“I had lots of thoughts of running away.”
”I had a plan that I was going to grab my passport and my university transcript, and I was going to get on a plane. For some reason, I wanted to go to Perth. Just in my head, I'll be okay once I get to Perth. I just was transfixed on this idea of escape, but I couldn't go anywhere because of lockdowns. It was just a good three or four months of being stuck in that cycle of: I need to get out, I can't get out, I need to get out, I can't get out, and just having a screaming child that did not sleep, did not eat! We're like pushing him to eat and gain weight and… Yeah, it just was a nightmare.”
“We did a day stay at Tresillian, I think, when he was six months old, and that helped with his sleep a bit, but I don't think I was there for long enough for them to realise just how bad I was.”
“Because my husband was, not a ‘full’ essential worker, but he had to go in to do some practical stuff at his job. There were days that he wasn't there and that I was the sole carer for this baby without anyone else with me and just dealing with his screaming for hours and hours and hours, and I would snap and I would definitely lose my cool and have to put him down and walk out of the room.”
“I think that's where my postpartum rage developed as well. The fact that when you have these moments of this intense rage, it's almost like you can't see what you're doing. The only way I can describe it really is a Jeckyl and Hyde situation, and that something in you just snaps and all of a sudden you're not you anymore.”
“I would literally put this baby down and walk out into the lounge room and I would have to throw a cushion against the wall or I'd scream into a cushion or I'd just stomp around out in the lounge room and just be like, I can't do this. I need to get out of this house, and I can't. Meanwhile, in the bedroom, Patrick is still screaming because he just doesn't want to sleep.”
“Luckily, I instinctively knew to put the baby down and walk away. That you'd have these flashes of you, like hurling a baby at the wall, and you'd be like, Well, time to put the baby down walk away. That's a very scary flash.”
“The pivotal moment for me is when my dog, Pepper, put her little front paws up on my knee and looked up at me, and I just screamed at her like, ‘Get off me’. She jumped down and cowered. I was like, ‘Oh, my God, what have I done? Who am I? This is not me. This is not the person I want to be. I don't throw things. I don't punch cushions. I don't scream profanities into cushions. Who is this woman and what's she done with me? How do I get my old self back?’”
“Then after you have that snap and you calm down, you then get that shame spiral that goes with it, and you go back into your screaming child, and you literally both just sit there and you cry. I would just sit on the floor next to his cot and we literally just both cried and it was horrible. I still don't know how we all got through it.”
At 10 months postpartum, Elyse, Bohdan, and Patrick did a longer residential stay at Tresillian which was the turning point - not only for Patrick’s sleep, but for Elyse’s mental health.
“I think by the time we got to Tresillian, I was at a point where any time my husband was around, I was completely disassociated from Patrick. Overnight, he would cry, and I would hear him, and I would wake up, and I could not move. I didn't want to move. I had reached that point where I was like, I physically can't do this anymore. I just couldn't bring myself to get up and deal with him anymore.”
“I pretty much cried the entire time we were there. From the moment we walked in the door, any time they asked me to do anything with him, with his sleeping, with his settling, I just cried. I would sit on the bed and I'd cry.”
“It was the nurses there that said, ‘You need to see someone… You just really need to go and talk to our social worker.’”
“Then I got in to see her and she said, ‘I really think you need to see the psychiatrist here, and I think you need to see her now!’”
“It was actually a good thing. I knew I needed help, but I didn't want to say I needed help. I don't know where that's come from because I've had therapy in the past and I've dealt with depression and anxiety and PTSD from when I was a teenager, pretty much. I just don't know why it was different this time for me, but it was very different. I don't know if it was because of the COVID lockdowns and being unable to get anywhere, not being able to have someone come to my house and mind Patrick, so I could go to therapy and see someone and talk to someone about it. But it all felt like it was too hard until someone actually said, ‘No, it's not too hard, and we can do this and we can do this right now.’”
“I don't know where we'd be if it didn't happen. I don't think I could have kept going the way that I was going without help.”
“The psychiatrist there, we had a few sessions, but the main thing she did was put me on an antidepressant, anti-anxiety medication, which is something I, like when I had depression and anxiety as a teenager, it was something I never really ever wanted to do. I was quite happy to put my resources and time and effort into doing the cognitive behavioural therapy. That's great when you're a teenager and you've got high school and you've got three sessions a week for an hour… I just didn't have the time or the headspace to do that again.”
“I thought I am going to do it and I'm going to start medication. I know that they don't work straight away. It's not like you take a blood pressure medication, your blood pressure drops. They do take a week or two to kick in, but I felt so much better even after a couple of days of taking them. I don't know if it was the placebo effect or if they had actually started working very quickly, but it just felt so much better.”
“I felt like I was more in control of my emotions and more in control of my rage, and that I could have Patrick scream and cry and carry on, and I could comfort him. I didn't feel like my brain was on fire, like I needed to escape. For me personally, the medication really helped. Once I was able to get a little bit in more control of my emotions and was able to come down off the precipice, I could then start doing some of the cognitive behavioural therapies that I had, the techniques that I had learned in my teenage years, in my early 20s to help manage the rest of my depression and anxiety. For me at that time, the medication was definitely a godsend.”
“[Tresillian] was honestly such a good stay and a good service. I stayed at the one at Canterbury in Sydney, and yeah, they were just phenomenal there… it was really such a great service to be linked to. They even had support groups for the dads there and support groups for the mums there. Yeah, it wasn't just come in and pat your baby for five minutes and then shush for five minutes and then repeat.”
“In the middle of the pandemic, I went back to work and I felt like I had regained a huge part of myself by going back to work and relinquishing that control with Patrick a bit as well. I didn't think I would be a controlling parent, but here we are, and there we are in the middle of pandemic and I guess you just do what you have to do to survive. With him being not great with his sleeping and his routine, we were quite strict schedule parents. So getting a nanny in and relinquishing that control, I think, also helped me a bit as well, just to step back a bit.”
Elyse reflects on where this control stemmed from, and a lot of it goes back to the midwife’s comment at the start of her journey. “I think from that moment on, I was like, ‘right, I'm documenting everything’. Because if you don't document it in nursing, it didn't happen! I bought an app. I bought one of those baby tracker app things, and literally everything he did went into that app. His feeds, his wees, his poops, his sleep, his awake times, his activities, you name it, went in that app. I still have the app on my phone, and I think I could look back and tell you exactly what he was doing and what time of the day he was doing it.”
“It sounds so weird saying it, but it was a hard time stopping the documentation of Patrick. I feel like it probably went on until after he was a year old. But this app, just I kept putting in everything in the app. I think Bohdan even said, ‘I think it might be time that we stop doing this… I think it's time to let go.’”
Shortly after, Elyse went on to welcome twins which, to everyone’s surprise, was a very different experience.
“It really was absolute chalk and cheese experience between both the pregnancies, both births, both my postpartum periods. It's just been, yeah, it was so weird how different it is.”
“I hate the term ‘difficult baby’, you know what I mean? But he wasn't easy. He wasn't easy to feed. He wasn't easy to settle. There was a lot of purple crying. Then even after that fourth trimester stuff, there was ongoing sleeping and feeding issues.”
“With these two, the pregnancy was hard, physically hard, like carrying two babies, two placentas, two lots of fluid. It was difficult. I reckon I almost had my own gravitational pull - I was that big! It's a sight to behold a twin pregnant belly. Again, very lucky to have an obstetrician who supported me in a beautiful way. I was induced, but a beautiful vaginal delivery of both of them, and very lucky to have that initial skin-to-skin with both of them.”
“Arthur, who was born second, was born breach, so he did need a bit of special care support. He came out with a bit of fluid in his lungs, so he needed a little bit of resusc and a bit of bagging to clear his airway and suctioning and stuff. He was on CPAP, I think, for like half an hour an hour in the delivery suite and then was moved to special care on oxygen. But even that, I guess with my nursing background and I knew what was happening and they were very good at telling me what was going on, so I was very calm about all of that.”
“He had a cry on him and he did sound gurgley, but he was making noise and he was very vocal in his protesting about everything being on to the point that they had to prone him. They had to put him on his tummy because he kept pulling everything off and he was taking everything off. I was like, Okay, ‘so he's a little fighter, so that's fine!’”
“Bohdan was updating me about his progress. I was so lucky to have Madeline on me pretty much the whole entire time that I was there. She was moved to special care in the evening just for blood sugar monitoring because I had gestational diabetes in both pregnancies.”
“But yeah, these two came out and we knew straight away that I would do comfort feeds with breastfeeding. I was more than happy to attach them whenever they wanted to be attached, but we knew that they would need to be bottle-fed pretty much from the get-go, and that their main source of nutrition would be bottles.”
“All the midwives at the hospital knew my situation, and they were more than happy to support me in that decision as well. It was such a big relief to be supported in that too.”
“I don't know if I'd had a singleton for my second pregnancy, I would have been as supported in bottle feeding as I was with twins. I don't know. But yeah, everyone was like, ‘Oh, yeah, twins. No, that's fine. You can bottle feed.’”
“So yeah, at least something to take the pressure off and just being able to not spend six hours of my day on a pump! And props to anyone who does pump for that long like you are super women, superstars, because I couldn't do it.”
“But yeah, very different the second time around. I mean, having said that, you do feel like a drill sergeant when you've got twins. Again, you're very scheduled and you're very like, ‘Okay, feed this one, feed that one, burp this one, burp that one, change this one, change that one, settle this one, settle that one, feed again.’”
“One thing that stuck in my mind was my mom going, ‘Is Madeline due for a feed now? Or is Arthur due for a feed now?’
I'm like, ‘To be honest, I actually don't know.’
She's like, ‘Don't you have that app thing?’ I'm like, ‘I'm not even using the app this time. I don't know. I don't know. Just feed whoever's crying at the moment, just feed them! They're fine! We'll sort it out again. We'll get back on track the next feed, I'm sure.’”
“Yeah, it was just such a different experience, just being so chill about the whole thing.”
Despite still being in lockdown during her pregnancy, Elyse was surrounded by incredible support throughout this time and her postpartum.
“Because 2021 was a lot of COVID lockdowns and stuff, I pretty much went to every scan and appointment solo, which my poor husband, like poor Bohdan, was left out quite a lot in that respect. But my sister is a flight attendant, so she opted to work 2020 and the majority of '21 and opted to be stood down around my due date. She joined our household and came and lived with us. She was like our living, extra set of hands.”
“She now has such a beautiful bond with Patrick and Madeline and but was very hands-on with Patrick mainly, just so Bohdan and I could deal with the twins and make sure Patrick then wasn't left out. Because bringing home one baby is one thing for a two-year-old, but bringing home two babies is one hundred for a two-year-old… Yeah, she's a champion. So selfless.”
Regarding her postpartum with Patrick, Elyse says “I think I was so controlling that people just stepped away a bit like, ‘Oh, she doesn't need help. She doesn't want help. She's doing it all herself.’”
“This time, though, anyone came into my house, it was pretty much like a football toss. ‘Here's a baby. Here, take a baby. Do you want two? Just one? Okay, you take one.’... Restrictions started easing up when they were only one or two months old, so people started coming over, and literally anyone that walked in the door got a baby. ‘Here, here's a bottle, sit down, make yourself comfortable!’”
”It is next level. But also, I guess knowing that everything is just a phase and knowing that the second time around, like the first time around, you don't have that insight of how quickly they change and how quickly they do change. It's just mind-blowing!”
“Also there are lots of supports for twins and multiples parents out there.”
“Australian Multiple Birth Association [AMBA] is an Australian-wide association, and they have their little local branches. I am a member of SAMBA, Southern Sydney Multiple Births Association. They link you with other mothers in your area who have had twins or multiples. It is amazing. We have such an amazing group of mothers who just get it, the twin and the triplet factor.”
“Look, I'm going to keep it real for you, because let me tell you, Patrick almost broke me. It really is dependent on the baby. If I had two Patricks as the twins, it would have been a hard slog. It would have been probably back for another residential stay at Tresillian and back to the psychiatrist again. I just couldn't imagine having twins that are collicky - I know that's an outdated term - but reflux or unsettled babies, babies who fight sleep or those babies that just don't go with the flow… We're all different people and babies are just little people and they are all different. I really do think Patrick honestly prepared me for having twins. It was probably a reason I had Patrick first. I mean, he's a champion now. He's an absolute champion. He's a spitfire, but that first 12 months of his life were next level.”
In comparison to her pregnancy and postpartum with Patrick, Elyse was taking anti-depressants prior to conception with the twins. “I initially started on Zoloft, but yeah, that was giving me night sweats. Then changed me to Citalopram. I was on that for my whole conception, pregnancy, postpartum period, and called MotherSafe about being on it with trying to conceive and spoke to my obstetrician about it and they were happy for me to continue on. I wasn't on a very big dose. They were like, ‘Look, your mental health is probably worth it!’ I think it's a category B, so it's not that it's dangerous, but it's not tested because it's not ethical to test on pregnant women, that kind of thing. Yeah, definitely still on the medication now.”
“I still have my moments. I still get, still get, shouty. I am very outnumbered. They gang up on me!”
When Elyse reflects on what she wish had been said to her during the hard times, when she was diagnosed with IGT, she leaves us with this incredible message:
“It's not your fault… it's not your fault that your body's like this and that there's no shame in the fact that your body can't do this, this thing that we're told that we're supposed to be able to do, it's not your fault. If you don't want to breastfeed and it's too hard for you to breastfeed and it's causing you too much emotional anguish and stress, don't do it. Go easy on yourself and don't put that pressure on yourself. I really wish someone had told me that. I felt like I had to, and I had to keep trying like there was going to be some miracle cure for it, but there wasn't.”
“Feeling like you have to justify it to everyone and then explain your situation, I’m sure people don’t care about my boobs that much, but I would have a good five-minute conversation about my breasts and why I couldn’t breastfeed. I honestly think I went back to work and people knew about it and they were like ‘Whoa! This is a lot, Elyse!’ I’m like, ‘Oh, I’m sorry! This is just how it’s been the last 14 months of me trying to justify these decisions to people!’”
“Everything in motherhood, I just feel like it doesn’t matter what you do. You’re judged either way… Honestly, it doesn’t matter what you do. There’s no winning.”