21 Sep

No Big Deal

The thing about breastfeeding is that the milk production system is dynamically stable, provided you don’t mess with it, and you ensure it’s operating effectively. The system has all these different elements that facilitate its stability and effectiveness, and when these elements are undermined or misunderstood, that’s when it goes wrong. Sadly the culture we live in is big on the undermining and misunderstanding of breastfeeding, and that’s why the majority of women stop doing it before they feel ready.

Here are some of the indredients in the recipe for no-big-deal breastfeeding.

  1. A newborn baby has a stomach capacity of around 5ml. A teaspoon of colostrum (the kind of milk you have when your baby is first born) is therefore big enough to fill it. It is likely that the tiny tummy will both fill and empty quickly, and therefore need to refill frequently. (Undermined by the idea that colostrum is insufficient therefore artificial milk needs to be given, therefore breastmilk production system insufficiently stimulated).
  2. Short frequent feeds stimulate the milk to change from colostrum to mature milk, which happens over the next days. (Undermined by the idea that baby’s frequent demand for the breast indicates a problem with breastfeeding, when in fact it may be normal, or it may indeed indicate some problem that could be dealt with. Offering artificial milk does not deal with this problem).
  3. Newborn humans are highly dependent and inherently appealing. In cultures where ‘lying in’ is practiced, the newborn’s needs to be close with his or her parents are naturally fulfilled. (In cultures where governments spend 14 pence per baby on promoting breastfeeding, and baby milk manufacturers spend £20 per baby on promoting formula, such as the UK, we have tended to forget about the baby as a person with needs, and started to cast it as a demanding creature that makes its mother’s life difficult). A baby who is kept close to his or her mother is likely to feed little and often, stimulating the milk supply and growing well.
  4. When the change in the milk occurs, around day 4, there will be a lot of milk in the breasts. This is called engorgement. It is what it sounds like. It is important to get this milk moving out of the breasts, using baby or pump as necessary. That’s because milk contains something called Lactation Inhibitor, and if the milk remains in the breast then the LI informs the body that milk is no longer needed. Milk production then decreases or ceases. It’s also because the baby needs to feed on the milk.
  5. Breastfeeding should not be painful. Pain indicates a problem. The majority of the time, the problem is something to do with the way the baby is held, or the way the baby attaches at the breast. The majority of the time, such a problem can be dealt with by giving careful attention to these things, finding a way to make mother and baby more comfortable. If the baby is well-attached, the mother should feel no pain. If the baby is well-attached, then he or she can feed effectively, giving the correct level of stimulation to the milk supply, keeping mum from getting engorged, and consuming enough milk to sustain his or her own growth and development. (Undermined by the phrase of course it hurts, what did you expect? leading mothers to persevere through pain and misery to the point at which it becomes unbearable, and they stop.
  6. Newborn humans may be highly dependent and helpless, but they do have the ability to signal when they are hungry (see above), and stop feeding when they are full. Therefore it should be possible to feed the baby on cue, for as long as he or she needs to feed, without pain, and for breastfeeding to work. (Undermined by pressure from ourselves or others to be in control of the chaos, to get back to normal, to have a life, etc etc etc).

I see a big circular diagram with lots of arrows connecting all these things together. The challenge for me is to convey to pregnant couples that for breastfeeding to work well and fit easily into one’s life (an oft-stated aim), it is necessary to optimise all of these elements. I fear that what this comes across as is an edict that you have to Give In To Your Baby, otherwise you are a Bad Mother Who Never Really Wanted to Breastfeed Anyway. Our modern culture clashes horribly with the needs of a breastfeeding mother&baby. I can understand how hard it is for so many of the women I meet, coming from Important Jobs and busy lifestyles where they are used to having control and predictability. Many work until very shortly before the baby is born, and it seems to me when I meet them in classes that the baby is still very abstract, and their idea of what life is going to be like is unrealistic. Perhaps we should be encouraged to stop working a good month or more before the due date, and spend that time hanging out with new mums (Hm, isn’t that what NCT Bumps and Babies groups are for?). Initially this would be disastrous because all they would hear is the horror stories, but perhaps slowly an understanding of the necessarily fuzzy boundaries of new motherhood might develop.