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Podcast: Ep 25 - Breastfeeding stories ... finger feeding and returning to the breast

Sarah's story of persistence

Emma chats with Sarah about how she overcame an incredibly difficult start to breastfeeding her third child with a huge amount of persistence, determination and support.

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Sarah's story of persistence

Emma chats with Sarah about how she overcame an incredibly difficult start to breastfeeding her third child with a huge amount of persistence, determination and support.

Links to resources and information discussed in this episode:

Credits: This episode is presented by Emma Pennell. Featuring Sarah. Audio editing by Jessica Leonard. Show notes by Belinda Chambers. Transcription by Laura Allison. Produced by Belinda Chambers, Jessica Leonard and Eleanor Kippen.

Episode transcript

JESSICA: A listener note, this episode contains brief reference to birth trauma. Listener discretion is advised.

SARAH: At the time I had mixed feelings about it. I felt devastated that I couldn't give her enough myself. But I was also grateful that when I couldn't do that, my community were there to lift me up and do it for me. Yeah, I'm getting teary thinking about it, because it was just the most wonderful gift that anyone has ever given me that they brought their milk so that she could have enough.

EMMA: Welcome to Breastfeeding with ABA. A podcast brought to you by volunteers from the Australian Breastfeeding Association. Breastfeeding with ABA is a podcast about breastfeeding made by parents, for parents. In this episode, we'll be talking to Sarah about how she overcame an incredibly difficult start to breastfeeding with her third child with a huge amount of persistence, determination and support.

We're recording this podcast in different parts of Australia. We acknowledge the Traditional Custodians of the lands on which we are recording and to which you are listening to this podcast. We pay our respects to elders past, present and emerging, and to any Aboriginal people who are listening today. We also acknowledge the long history of oral storytelling on this country and of women supporting each other to learn to feed their babies.

In each episode, you'll hear from different ABA volunteers around Australia. My name is Emma and I'm a volunteer breastfeeding counsellor with the Australian Breastfeeding Association, and a mum to two children. I am speaking to you from the Yarra Ranges in Victoria and Wurundjeri country.

Today we're talking to Sarah. Sarah, could you introduce yourself, please? Just tell us your name, where you're speaking from and about your children.

SARAH: My name is Sarah. I'm speaking from Quandamooka country in Queensland, and I'm a parent to four children, four daughters. The youngest is 10 months old and the oldest is 8 1/2 years old and I have been breastfeeding non-stop for eight and a half years now.

EMMA: Wow, that's a really long time to be feeding for. So today we're mostly going to be talking about what happened when you were breastfeeding your third daughter, but could you tell me a bit about what your breastfeeding experience was like with your first two children, what sort of expectations did you have about breastfeeding the first time around?

SARAH: Uh, when I was pregnant with my oldest, I didn't, I didn't give breastfeeding much thought because I just assumed that breastfeeding would be easy and that it would come naturally. I had only seen breastfeeding around me growing up. I don't recall ever seeing bottle-fed babies, so I just assumed that was the way you feed a baby.

So, when my oldest was born, I was lucky and it did, it came really naturally and really easily and we just did it. And it was similar with my second baby. I was an expert by then; I'd breastfed my oldest for two and a half years. And my second baby was even easier, so breastfeeding was just something that was really normal for us, for our family.

EMMA: Then you gave birth to your third daughter. Can you tell us a bit about what her birth was like?

SARAH: She was my first home birth and it was really fast. My labor was an hour from start to finish. It was, it was rushed and it was frightening for me. So when she was born, we were both in shock. She didn't breathe immediately. There was some worry and some concern, and it was really stressful. It was a really traumatic birth for me, emotionally and physically. In hindsight, I think it was also traumatic for my baby.

EMMA: Yes, it really, it might have been. So, what was the first breastfeed with her like?

SARAH: She breastfed maybe an hour after she was born. We were in my bed, tucked up skin to skin, doing all the right things. At the time I didn't, it didn't strike me as different to any other breastfeed. It seemed normal, she latched but in hindsight, I don't think she latched well even then she didn't do the lovely breast crawl, that you often see when you are skin to skin after birth. She didn't do those breast seeking behaviours. She seemed stunned when I think back on that time, she seemed stunned from her birth. But she did, she breastfed, it was all lovely. You know, big sisters sitting on the bed with us. It wasn't until later that I started to think there might be a problem.

EMMA: So, when did you realise that that things weren't going well with breastfeeding? What were the first sort of signs that you noticed?

SARAH: On about day two, I started to feel worried that something wasn't quite right. At that time, I didn't, I didn't really notice any physical signs, I just felt different. I remember bringing it up with some of the people that we had in the house at the time who said, ‘oh don't worry about It, you're good at this, you know you've done this before. Look at her, she's latched, she's happy’. And it didn't, it didn't make my anxiety about it subside, I still felt worried.

And then by day 3, somewhere on day two, day three, I started looking at physical signs and I realised that she hadn't had that kind of mustardy baby poo yet, she was still having meconium poo. When she did, she didn't have many poos, she wasn't having enough wees, and that really tipped me off that there was actually something wrong. So I looked a bit harder and I realised she was sleepier than my other babies had been, and there were probably a few other things, um she had a bit of a shallow latch, and when she was swallowing it was a gulping sound, like an irregular gulping sound that I hadn't heard with my other babies and it just all seemed very off, so I called in some support on day 3.

EMMA: And I guess as an experienced breastfeeder, as you were, those signs may have been a little more obvious to you, or obvious to you earlier than it might be if you were a first-time mum at the time, right?

SARAH: Absolutely, I would not have recognised those signs with my first baby at all. 

EMMA: Although as you say, in some ways, it also sounded like it was could have been a slightly double-edged sword as well, because you had mentioned the first time you brought it up with someone that you were concerned, they say ‘oh no, you're fine you can do this, you've done this before’.

SARAH: Absolutely yeah, yeah. Everyone expected it to go well because it all had before.

EMMA: Yeah, so what did you do next once you really knew that things weren't going well? What was your next step?

SARAH: Ah, I called in so much support on day three, day four, day five after she was born. Funnily enough, one of the first things I did was call a friend who was breastfeeding her young baby and asked her to come over and breastfeed my baby to see if it was me. I thought it was a me problem. There's something wrong, I'm not doing this right. And so she came over, and she tried to breastfeed my baby and it was still ineffective. She got more milk from my friend because my friend already had established [her] milk supply. She had a 6-week old or something so she was getting more milk because there was more milk available, but she still wasn't managing the flow and the suck. So, then I called two friends who were breastfeeding counsellors with the ABA and said you need to come and visit me and help me with this baby. And we went through all of those basic latch positioning things that breastfeeding counsellors do really well, and that didn't help much either and so I called a lactation consultant and my midwife and they both came to my house as well. So, we had lots and lots of visitors over the course of two days, yeah. One of them, the midwife or the lactation consultant, pointed out that she seemed to have a tongue tie, so we decided to book in to have that cut straight away.

EMMA: And how did you feel about that diagnosis? Do you remember what sort of emotions that might have brought up for you at the time?

SARAH: At the time I was just panicking because I wanted to fix the problem. I was willing to accept any, anything, any diagnosis, any way to fix the problem without too much thought. In hindsight, I wish I’d managed the situation differently, but we all look back and seeing, you know, how we could have navigated things better.

EMMA: Absolutely you can only, you know, work with what you know and where you're at, at the time to make these decisions. And yes, later when you have more information, you might say, ‘oh yeah, I wish I'd done it differently’, but you didn't know, all that you know now, when you made those decisions.

SARAH: Yes when you make the choices, absolutely. So we managed to, I guess, book in very, very quickly to have the procedure done to cut the tongue tie before we’d even really made the decision to do it, we were able to book in.

EMMA: Yeah. Hey, so then what happened when she had her tongue tie released?

SARAH: She was 6 days old when we had the tongue tie released and she bled a lot during and after the procedure. It was really scary, was really, really scary to have a tiny newborn baby covered in blood. She needed some medical attention afterwards, but immediately following the procedure on she, she didn't latch anymore. She wouldn't try to latch. Ah, she cried if I brought her near my breast, so we had, we had extra problems immediately following the procedure.

EMMA: Oh my goodness. So instead of making things better, it actually made things worse for you, by the sound of it.

SARAH: Yeah it did. It made things a lot worse and a lot more urgent because I wasn't able to get any milk into her. 

EMMA: Oh my goodness, that would have been an awful thing to be experiencing as a mother. So, what did you do next? I mean, so here you now have a baby who you are not able to latch at all, but you need to get some milk into her. So how did you manage that?

SARAH: So again, we worked with the same lactation consultant, the same IBCLC that we'd spoken to a couple of days earlier. And she introduced me to finger feeding with a syringe, and initially it was really small amounts of milk, she was still only such a little baby and I was able to express, what at that point was actually still colostrum, because she hadn't been able to bring my milk in, I still had colostrum. Yeah, so I was hand expressing enough to fill a 10 mL syringe and then finger feeding back to the baby.

We did that by putting a tube, it’s called a French feeding tube, you clip it on to the end of the syringe, and the tube and your finger go into baby’s mouth together and baby sucks on your finger and she would do that. She would suck on my finger, which she wouldn't do if I tried to put her to the breast. So I would hold her in a breastfeeding position with a syringe in one hand and my other hand kind of twisted around and the finger in her mouth to feed her. And so we did that to get milk into her straight away and nappies looked better within a few hours of starting that, she was getting more wees she was getting poo.

EMMA: That must have been such a relief for you.

SARAH: Yes, it was, she was finally getting milk and so I started pumping, which was something I haven't had to do with my first two children at all.

EMMA: Before we go into that, could I just ask, why did you choose to try finger feeding rather than bottle feeding?

SARAH: At that point it actually didn't even occur to me to give her a bottle, or offer her a bottle, because I wasn't going to bottle feed, I was going to breastfeed. So it wasn't something that I even considered as an option. This finger feeding seemed more like a temporary fix until she started breastfeeding again, so it was never going to be a long-term solution.

EMMA: Yeah, that makes perfect sense. So you’re needing to express for her in the short term at least, and you know, I know for a lot of mums, expressing breast milk doesn't always come easy. How was it for you?

SARAH: It was not easy for me. With my oldest daughter, I had an oversupply, I leaked for nine months. With my second daughter I was similar and then I started pumping and I couldn't get any milk out. My body does not like pumps. So I had to pump two hourly around the clock. Initially I was getting nothing. Within a few days I was getting a small amount. And it did steadily increase for at least a month of our pumping journey, the volume that I was getting. I did all of the things that ABA recommends to get the most milk when pumping. I held my baby while I was pumping, I sniffed her little head, I did breast massage and breast compressions. And I ended up having to take prescription medication as well to increase my supply while I was pumping.

EMMA: Gosh, sounds like so much work. And what did you do to, I guess, make up that shortfall in in the early days, especially when you're saying you're hardly getting anything. Did you need to supplement her feeds with anything else to make sure she was getting enough milk?

SARAH: I did, I did need to supplement her. Initially I was lucky I had a lot of breastfeeding friends and they were able to pump milk and drop it off for me. So, she was getting supplementation from at least four of my friends, which is actually really special now that I look back on it.

EMMA: It is, what a beautiful community support you had there.

SARAH: Absolutely it, at the time I had mixed feelings about it. I felt devastated that I couldn't give her enough myself. But I was also grateful that when I couldn't do that, my community were there to lift me up and do it for me, so I'm getting teary thinking about it, because it was just the most wonderful gift that anyone has ever given me that they've brought their milk so that she could have enough.

EMMA: That really is amazing.

SARAH: It was so special. And as time went on and I had more milk available for her I needed less and less of that donated milk and when our pumping journey ended I was actually able to donate some milk to somebody else that was in my freezer because I was never going to use it again. So it ended up going full circle.

EMMA: Oh, that's lovely that you were then able to pay it forward to someone else as well. That's a beautiful bit of this story, I think. It's still incredibly yeah busy for you at this stage in your life I'm imagining, so you're exclusively expressing and finger feeding your third baby while also caring for two older children. 
Thankfully, you had these beautiful friends who are also expressing for you and dropping off milk for you so your baby was getting plenty of milk. What other sort of support were you able to get at this time? In terms of just managing all that workload in terms of your emotional and mental health.

SARAH: Yeah, well, looking back I actually don't know how we survived that time. But we did. And I had so much support and I think that’s how we made it through. My partner was at home for a few weeks after she was born. He usually worked away. So we had that extra hands at home that I wasn't used to having all of the time. And my mum who lives two hours away, for months she came and stayed with me Monday to Friday and only went home on the weekends, and she looked after the girls and she cooked meals. And she did my washing and she did my dishes and she hugged me and she would get up in the middle of the night at 3am, when she heard me in the rocking chair, pumping and crying. Uhm, she was just amazing.

EMMA: What a wonderful mum you have.

SARAH: I have the best mum. She, yeah, she was wonderful through that and my, you know, partner as well. He did all the practical things and he did all the looking after the children and took over all of those things that I normally did just so that I could look after the baby. We had a lot of medical appointments in the early weeks to try to work out what was going on and to monitor her after the procedure with the blood loss, and so either my mum or my partner would come with me to every appointment. So, I always had a support person, and the other would look after the children. So, we worked as a really good team. I would love to have that all of the time as a parent. We need three parents in every household.

EMMA: Absolutely, it's that village, isn't it? That we're always saying that we need and it's wonderful that you were able to pull together a village when you needed one that, yeah, it is a shame we don't always live like that.

SARAH: All of the time, yeah. We also worked with two IBCLCs throughout the whole… hang on it sounds like a baby needs me.

EMMA: That's OK, so recording again.

SARAH: OK.

EMMA: I’m trying to remember what we were talking about.

SARAH: Yes, sorry.

EMMA: You were telling me about, we're talking about support.

SARAH: Yeah, yes we also had the support of two.

EMMA: Ah the IBCLCs exactly, yeah.

SARAH: So we continued to see fairly frequently, the initial IBCLC that we’d called and she offered me just so much reassurance and support, and we tried lots of different techniques with her for getting baby to feed and streamlining our feeding process. And she would come to our house, and she was just the most nurturing, loving human ever. I'm still friends with her to this day. And so she offered even more of that village experience and really reassured me that what we were doing was working and that we could get back to breastfeeding.

EMMA: That's wonderful, we should just say in case anyone listening doesn't know the acronym that IBCLC stands for. International Board Certified Lactation Consultant.

SARAH: Yes, and we worked with another as well, who was also an oral myofascial therapist and she gave us lots of exercises and things to do with baby and they were a really important part of that process of getting her to feed again. So we also had friends, oh so many friends making food, making biscuits coming and, sitting next to me in my rocking chair while I just pumped and fed and pumped and fed and pumped and fed. So we were really lucky, we couldn't have done it without so much support that we had.

EMMA: That's fantastic, so how long did you end up, you know, going through this whole thing for. How long did you express and finger feed your baby for?

SARAH: I did that for almost six months. It was not the plan at the beginning. At the beginning, I thought this would be a few weeks at the most, a few days, a few weeks, but I just was never willing to give up on her being able to breastfeed again and it was less stressful and less harmful for my mental health to continue to express and finger feed than it would have been to stop and give her bottles or formula.

People, health professionals, friends, in a well-meaning way, kept saying to me you've done so well. It's OK to stop. And it was true, it would have been OK to stop, except I didn't want to. That wasn't what was best for me. And I preferred, when other people said to me, what can I do to help you keep doing this, and to get to where you need to be with baby. And that was the help that I really, really appreciated. The people that recognised that, that was the better option for us. Yeah, what was harder. 

EMMA: Yeah, absolutely, and because it's such a personal thing really too. For other people it might not have been the best option, but for you it was and that's what's important to recognise there I think.

SARAH: It is, yeah, about, I think it's important to recognise that people have different goals and it's really important to know what I guess a parent wants to do and wants to achieve when supporting them, I'm not sure.

EMMA: No, absolutely, I think it's so important as someone wanting to support new parents, especially someone who is going through a really difficult start to breastfeeding or a difficult time with breastfeeding at any point in the journey that we're listening to what they're wanting, you know how they're wanting to be supported rather than just making assumptions about what we think is the best sort of support.

SARAH: Absolutely yeah, absolutely. So we kept that up for nearly six months. We changed what we were doing several times, but it was always finger feeding and we ended up moving to a supplemental nursing system rather than the syringe. Which is basically a container with some tubes that come out of it and you fill it with milk and you hold it up on your shoulder or in your bra strap and the milk flows down the tubes. And so I would hold her again always against my breast, as though she was breastfeeding every single feed and I would finger feed as though my finger were the nipple with the tube running alongside it in her mouth, and nobody else ever fed her. I was really adamant any time anyone else offered, ‘hey, we can feed the baby for you’, that I feed my babies. I feed my babies my breastmilk and that's how it is. So we kept it as similar to breastfeeding as possible through the whole process, and I think that was one of the things that helped her to come back to actually breastfeeding in the end. 

EMMA: Yeah, so one term I remember hearing to describe feeding a baby like that is ‘at breast’ feeding.

SARAH: That's lovely.

EMMA: Yeah, it's like you know, and I think that's exactly what you're describing you were, you were feeding her at your breast, even though she wasn't feeding directly from the breast, and I think.

SARAH: Absolutely and that’s a perfect description, I've never heard that before. It's perfect. Yes, yes, absolutely, because I'd always have her chin, or her cheek, sorry, against the skin of my breast. I’d always make sure I was wearing a shirt that I could pull down enough that she was still skin to skin with me, as though she were actually breastfeeding.

EMMA: It's about giving babies who are unable to breastfeed for whatever reason an experience as close to breastfeeding as possible. 

So how did she come back to the breast? What happened to enable her to be able to do that?

SARAH: I think it was a, it was a slow progression. There was no one magical fix that suddenly worked. But I think the things that did help with that process was the finger feeding and the holding her in the breast position. I also, when I wasn't feeding her had her skin to skin in a baby carrier all of the time. Usually if I was at home I would wear no shirt under the baby carrier and she would just be in there kind of nuzzled into my chest and … 

EMMA: Skin time is so magical. 

SARAH: It is magical for all babies. It's so important. 

EMMA: That’s wonderful you found a way to, yeah, really maximise the time you could spend doing that.

SARAH: Yeah, I there wasn't a huge amount of time in the day that I wasn't feeding or pumping but we were able to do that in between, that skin to skin in a carrier.

EMMA: Yeah, yeah.

SARAH: And we.

EMMA: And, and doing it in the carrier like that meant that you're still able to, you know, do stuff with your other two children at the same time.

SARAH: With the other children hands free, not that I was doing any, or much, cooking and cleaning at that time. But I was still able to do other things while I was holding the baby. We co-slept with, well I co-slept with all of our children, and so when she was a baby I co-slept with her as well. I would sleep topless, so that again she was getting used to being against my skin and comfortable and happy there.

It broke my heart when she would cry if I tried to breastfeed her, like getting her comfortable against my skin made it so much better. So, she could just be there next to me in bed overnight. And that's actually where she started breastfeeding first. So overnight I would keep a little cooler bag with the expressed breastmilk and the supplemental system next to the bed so I didn't have to get up overnight, and when she woke to feed, I would try to latch her first every time, and then she wouldn't, so I would do that finger feed and one time, one day she just one night she latched. Just she was sleepy enough and comfortable enough and that instinct kicked in and she just latched and she fed and it was the best. She had a full feed. She didn't even need the top up with the finger feeding after that breastfeed.

EMMA: I can only imagine the joy that you must have felt at that moment.

SARAH: It was incredible. It was so good. Once she started at night, she kept going at night, so for the last month, probably from when she was five months old, she would breastfeed all night and then during the day we go back to ‘oh no, I won't do that’. So we continued during the day.

EMMA: You can't trick me now, mum, I’m awake.

SARAH: I don't know what it was that eventually she just clicked, and she just realised, well I can do this all the time, and from the first time she had a breastfeed during the day, I remember she was in the carrier, so she was really supported and comfortable and safe, and she just moved her head and latched. And after that breastfeed, she didn't finger feed again that was it. She could breastfeed so, it was amazing, it was just such a sudden switch, suddenly she realized ‘oh, this is good. I can do this and this is good’.

Everybody, all the health professionals told me ‘OK, well just keep pumping and keep taking that medication and just be aware that this will be a slow progression’. And of course I just ignored them and it stopped within three days of her breast feeding because we didn't need it anymore. My milk supply just went through the roof the second she started breastfeeding again. I was leaking everywhere.

EMMA: Oh wow.

SARAH: Yeah yes, suddenly my body went ‘oh this is what, you know this is what I make milk for, a baby. And so we were able to stop pumping moving to feeding straight away and she was almost six months old.

EMMA: That's just amazing! And I love how it was all on your baby terms. She found her own way to it in a way. I mean you created the environment where she could do that.  

SARAH: Yes!

EMMA: You gave her all of the opportunities, but you didn't push her. It was a very gentle and loving way of going about it and I think that's really, really beautiful.

SARAH: Thank you. I, yeah I didn't want to push her I didn't, she got distressed and I never wanted to distress my baby so I just stopped trying to latch her, I just gave her that opportunity and it paid off.

EMMA: Oh, that's incredible. So wonderful that you persisted for so long. For those 5-6 months of expressing and finger feeding, and all of the work and the time that goes into all of that, it's really an amazing story. 
So, can I ask how long did she end up breastfeeding for after that, once she got the hang of it?

SARAH: Well, she was, she loved it once she got the hang of it, I remembered what it's like to have a, an older baby who breastfeeds constantly. And she continued to breastfeed until just before her third birthday. And the only reason she weaned then is because I was seven months pregnant with our 4th baby and she didn't like the taste of the milk anymore. So she breastfed really well as an older baby and toddler, and weaned on her own terms as well.

EMMA: Right, sorry, then you had a fourth baby and oh gosh, I mean during that fourth pregnancy, were you worried that you might end up having a similar experience again?

SARAH: I was, yeah, I was, I was terrified of giving birth again after the experience with our 3rd and then I was really, really scared of having a similar breastfeeding experience because by that point I had enough distance between the experience and now to look back and go, how did I do that? I couldn't do that again, I'm not going to do that again, that was impossible! So I was really worried that if that happened again, I wouldn't be able to replicate that level of dedication.

Luckily, we had another home birth and it was lovely, it was slow and calm and gentle. And when our fourth baby was born, she self-latched. She was on my chest on my bedroom floor where she was born and we laid there marvelling at each other, and she wiggled her way to my breast and bobbed around and did all those beautiful newborn things and just latched and fed and and it was so healing to have that happen.

EMMA: Must have been, yeah.

SARAH: It really was, but we then went on to have, we had a tongue tie again with my 4th baby. And it was worrying and it was scary, but we had the benefit of experience behind us and we were able to make more measured decisions. And it worked out a lot better than it had the previous time. So our last little one we saw the same signs that no, she didn't, she wasn't doing poos and stuff on day three, but instead we just straight, were able to start straight away with using a teaspoon to top up with colostrum so she didn't, she was always getting enough milk, yeah, and we saw a lactation consultant straight away and waited until 6 weeks and had the procedure done and it all just went beautifully and she has just been a beautiful breast feeder all along. So, I guess our third baby gave us those lessons that that we needed to have a positive experience again with number four.

EMMA: I'm so glad that number four was so much more positive. It must have been quite stressful, though. I guess when you first started to notice that, uh oh, starting to see some of the same signs I saw the last time. But yeah, having that, that prior knowledge, knowing that you could maybe try doing things a bit differently this time seems to have really helped.

SARAH: It did, it made it a lot easier.

EMMA: Is there anything else about your experience with your third baby and breastfeeding that you'd like to share with us before we finish up.

SARAH: I guess, it's so important to call in your community and your support network when things are hard. I mean, they're important when things are easy, but when things are hard, you call them in and have them there. We can't do these things without the people around us supporting us and helping us. And, yeah, I wouldn’t have been able to do this without my people.

EMMA: Yeah, and your story I think is a really beautiful illustration of that. Yeah, it was a community of people who helped you and your baby get through that experience.

SARAH: Yeah, yeah, and I guess also there’s, there's always creative ways to resolve breastfeeding problems and I guess finding those professionals or people who can help you to find those creative ways. If your goal is to do that to exclusively breastfeed, then there are different ways to go about achieving that and it and it doesn't always look the same.

EMMA: Yeah. Well Sarah, thank you so, so much for sharing your story with us today. I have really enjoyed talking to you and learning about your experience feeding your baby. 

You can find links to more information on this topic and this episode’s companion blog in the show notes. Visit breastfeeding.asn.au to learn more about breastfeeding, find your local group or join ABA as a member. You can also access our LiveChat service to ask questions about breastfeeding. Check the website for current operating times. To speak with a breastfeeding counsellor call the National Breastfeeding helpline on 1800 686 268. For online peer support from other mothers, join our Breastfeeding with ABA Facebook Group.

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