Write something for the blog they said, common breastfeeding issues they said. Mmmmmm, where to start. Well, there are any number of breastfeeding issues to consider as any new mum will tell you, but how often do we think about breastfeeding from the baby's experience? Baby feeding.
As a lactation consultant there is a moment experienced clinicians speak of as "learning to see the baby", and that it is THIS moment that marks your passage from novice to expert. I'd cared for many babies over many years and thought I'd seen plenty, and was a bit bewildered by that phrase I will confess. Then one day it finally happened. Suddenly, one day, with a Mum and Bub something clicked and I "saw" what that baby's behaviour was communicating, and my brain and professional practice lit up. Not only could I interpret better the signals the baby was giving, I stopped thinking about breastfeeding as something a mother did for a baby and saw what this little one was trying and wanting to do. I started to consider what this experience was for the baby. All this time I'd been missing part of the picture.
So, let's do that, and I'll bet it changes how you look at this relationship with your baby.
Where have they come from? A constantly warm place, held tightly, gravity somewhat negated by amniotic fluid, constantly nourished and never knowing hunger, they have however been practicing sucking and swallowing amniotic fluid and have a strong buried instinctive seek and suck reflex. Birth. Cold, suddenly unfurled limbs set free with amateur control, so many stimuli they have never experienced before and often influenced by medications administered to Mum during birth. And yet, despite all of this, most of them manage to successfully master a never before used skill within the first hour of birth (it is during this first hour they are the most primed for this early feeding activity) and latch on and suckle at the breast. In fact nearly all non medication affected babies can crawl to the breast and latch on if placed on the mothers abdomen (google breast crawl).
Biologically, babies are designed to stay with and on their mums to take advantage of her constant warmth (so as to use fewer calories to maintain body temperature) and when observed in a traditional culture, feed for short times, 1-2 minutes every 12-15 minutes. This pattern of feeding means that baby gets a more constant small flow of food more like uterine life and they never get 'hangry'. They also are only latched for short periods and less likely to cause nipple damage as they learn their craft, and the frequent suckling means that the milk producing hormones stay consistent. Babies also interact by crying, nuzzling and using skin contact and massage with their hands, which increases hormones that promote milk production. They feed frequently at night, as they instinctively know this also increases milk production and sets production rate high in the all important first two weeks.
My girlfriend who works in the third world rarely sees low supply problems in new mums. These new mothers are required to nothing more than rest with and feed their baby, an enormous and welcomed luxury in a very busy physical lifestyle. Another feature of biological feeding is that a newborn baby in the first few weeks tends to sleep more soundly and for longer periods in the day and then feeds frequently on and off most of the night as they lay next to mum as she sleeps. This works well as mum returns to normal family duties and this allows her to still get tasks done in the day and the bulk of baby nutrition at night. Great system?
Not so much in our western lifestyle and birth traditions and it would have to be the most common stress in new parents, why are they settled in the day and not the night? But nothing alters in a baby's physiology just because they are born in a western culture. We are all set on the one primal biological factory setting.
Our western feeding practice of spaced feedings and timings, separation of Mum and Bub and limitation of skin contact add to their normal transition challenges and some babies struggle more with this than others. They get the memo eventually, and it can be done, but it takes time and we can help them by having realistic expectations and meeting them in the middle till they adjust.
Breastfeeding is about a Mum, a baby, and, the breast. None of these is passive. All are amazing.
We have already thought about how baby works. Mum uses her physical skills, emotional response and hormones to keep her baby close to react when they cry, her body will raise its temperature by up to 2 degrees to warm her baby or lower her temperature if baby is too warm. Multitasking at its best, us girls are all over it! Each feed Mum's physical skills and relationship develop from an unsure, uncoordinated and concentrated activity to, over time, a smooth art. Like any physical skill (driving a car, playing an instrument) it's not instant. Mothers also have an untapped reserve of instinctive knowledge that they have not used till now. But it's there, it's why the first piece of advice from an experienced mum to a new one is "trust your gut". It's why experienced lactation consultants don't alter anything until they see what a Mum and Bub instinctively do together. It may not be textbook but might be just right for them.
The breast is not simply a milk container either. Nipples become more prominent when stimulated by a nuzzling baby's hands and mouth to aid latching. When a well latched baby has been sucking for a short time it causes a tightening of the milk sacs ('letdown') that store the milk and this pushes the milk down quickly to the baby so in fact, during this process the baby gets free delivery. The breasts learn to 'do a dance' with the baby in that how much milk is produced is entirely determined by how much baby drinks. Mum doesn't consciously dream up how much milk she will make, the baby and breast control this together. So much so, that by 6 weeks the breast is so efficient it no longer needs to have milk sitting in the breast between feeds. It starts to up production rate in response to hormones produced as Mum subconsciously picks up on non verbal sounds and body language from the baby to indicate feed time is approaching. Mothers instinct. As they get a little older, babies sing to and coo and smile at the breast, they have a relationship with the breast and have learnt over time to work the breast to meet their needs.
So let's be patient and let them do their work and settle in, then, after a bit we can tweak things to fit our culture, but first the relationship has to develop. Be human, let the 'littlest expert in the room' teach us about them and support them with patience as they learn. Hold them, and be near. Sometimes, for some babies breastfeeding will only work on their own biological terms and then we have to meet them where they are.
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