This “Got Milk?” post is third in a series I am putting together on breastfeeding.
A few months ago I posed this question to twitter:
“What do you think a new mother needs to know/hear about breastfeeding?”
“What do you wish someone had told you?”
@Jehefinner sent me the following message on facebook. I found it very interesting and informative and I wanted to share it with you all.
Why Breastfeeding Fails:
“Drugs commonly used to treat bleeding after birth may hamper a woman’s ability to breastfeed her baby, research suggests.
The study, which appears in the journal BJOG, suggests the drugs may impede milk production. The Swansea University team also confirmed high doses of painkilling drugs have a similar effect. The findings may help to explain the limited success of efforts to increase breastfeeding rates in the UK.”
This is not new news, Michel Odent has been saying this for 30 years, but it hasn’t been taken seriously, and still isn’t now. I did have a synto injection after I had Milly, and bled out 850mls. When I had Phoebe I opted for a physiological third stage (no synto injection to expel the placenta), including not clamping and cutting the cord until it had stopped pulsing, and I hardly bled at all. I know this is anecdotal, but the reasoning works this way; when the cord is left to stop pulsing before it is clamped and cut, not only does the baby get it’s full quota of blood [about 250mls/half a pint is in the placenta & cord] but the placenta drains, which may make it detach better, resulting in less bleeding.
Opiates (pethidine etc) and all pain relief, even epidurals and gas and air cross the placenta and effect the baby.
“The labour pain-reducing drug, pethidine, also interferes with this tentative, yet alert, exploratory behaviour by the infant. A newborn whose mother has received pethidine during labour can be dopey, unresponsive and disinterested in the breast.
Studies have shown that newborns exposed to pethidine have poor arousability for up to three hours after delivery. Poor arousability means there is slowness in the central nervous system and delayed and depressed rooting behaviour and suckling. The effects of pethidine can last for a long time – the elimination half-life of pethidine in a newborn is about 22 hours, compared with three hours in a mother.”
“In addition, pethidine readily crosses the placenta; if the drug is given too near the time of delivery, it can delay breathing at birth, make feeding difficult and cause the baby to be very drowsy. There is an antidote available, naloxone, which can be injected into the umbilical vein at birth, but it is not always given.”
“The researchers, led by Dr Siranda Torvaldsen, say: “There is a growing body of evidence that the fentanyl component of epidurals may be associated with sleepy infants and difficulty establishing breastfeeding.”
“A review of 21 studies comparing epidurals to other forms of pain relief showed women who chose them were 40% more likely to need intervention.
The Cochrane Review found this could mean instruments such as forceps being used to deliver the baby.”
“However, babies whose mothers were given a low-dose epidural took longer to become vigorous after delivery, and a few of the babies in the low-dose infusion group were more likely to require breathing assistance.”
Skin-to-Skin is important, washing, swaddling, dressing and testing done away from the mother all inhibit reactions and instinct. Left alone a baby will instinctively root and suckle.
“When the mother and midwife tried to help him latch on, he closed his mouth firmly and arched his back, pulling his head away from the breast.
When I went to visit this mother at her home, I could see that the repeated attempts to latch the baby on were making him feel increasingly unhappy about being held in the nursing position. As soon as he was held on his side and moved close to the breast, he started to fuss and push away. I suggested to the mother that she just concentrate for a little while on helping the baby feel relaxed and comfortable at the breast—just letting him lie there, close to the breast, without any pressure to latch on or feed.
She called me back several hours later, very excited, with wonderful news. She had been lying on her back, dozing, with her naked baby lying on his stomach on her bare abdomen just below her breasts. She noticed the baby beginning to squirm and wriggle and then, to her surprise, he pushed himself up to her breasts, his little head bobbing as he searched for the nipple. Then he latched on and suckled away. After several minutes of vigorous sucking, he let go and rested. She then gently moved him toward the other breast, and to her delight he repeated the process, latching on beautifully all by himself once again.”
are really good examples of how not to get a baby to feed, holding the head like this is really, really bad practice! These holds make babies flail their arms and arch away from the boob, holding a baby by the back of the head, or at the back of the neck as is commonly taught actually works against instinctive feeding behaviours.
But this kind of approach; http://www.biologicalnurturing.com/pdfs/Colson%202007%20non%20prescriptive%20recipe%20for%20BF%20put%20with%20recipe.pdf
triggers all the instinctive behaviours that help a baby to feed easily. Newborns have strong necks and like to lie well supported either on their belly or side, pressure on the soles of the feet also triggers a rooting response, so laying a baby on his/her stomach or side and letting them “stand” on your thighs (or the palm of your hand) as you recline on your back or lie on your side is the most natural way to feed a baby. Sitting bolt upright holding your baby by the back of the head and shoving a nipple in it’s mouth is neither natural or pleasant!
“Tell parents the stark reality of life with a newborn, rather than forcing them to question their instincts…………… But here’s the thing. Young babies are not meant to sleep through: that’s the harsh and horrible truth. They have a very real and primal need to know their mothers are close, that they are safe. Their tummies are tiny and so cannot hold much milk, so they get hungry often. And breast-milk – which, remember, is the natural food of babies – is extremely easy to digest so as not to put undue strain on an immature system. All of this adds up to a baby who wakes during the night. Darn those babies for not being self-sufficient.
This research also found that babies got “fussy” in the early evening and that this “unexplained crying” starts at six to eight weeks. Well, guess what? Six weeks is when a baby has its first growth spurt, so its need to feed often goes into overdrive (this is also the time most women who started off breastfeeding stop, because they think they haven’t got enough milk).
And babies get fussy in the evening because they are starting a natural, primal process that will eventually help them to sleep through (if we don’t interfere with it): they tank up on milk, most often between the hours of 7 and 10pm. If you don’t know this then the crying becomes “unexplained and unexplainable”. And can take you to the brink of madness.”
Expect your baby to want to feed, seemingly all the time, for the first few weeks. No baby in the whole world ever goes 3-4 hours between feeds happily or naturally. A breastfed baby is more likely to want to feed every hour or so, and there’s nothing wrong with comfort sucking. It’s natural, it’s normal and it’s good for the baby and your milk supply. A newborns tummy is the size of it’s clenched fist, ie, very tiny. It is easily filled and quickly emptied, so needs to be re-filled regularly. Allowing your baby to “comfort suck” means s/he is constantly topping up this tiny tummy. Contrary to popular wisdom babies can also suck and feed whilst they are dozing, so if your baby seems to be asleep, but is still sucking gently, then leave him/her there. They are only deeply asleep if they relax totally and voluntarily let go of the nipple.
Expect to get very little sleep for the first few weeks, especially if your baby is sleeping in a separate cot or moses basket. A newborn baby that can’t feel and smell it’s mother is an unhappy newborn baby. They have an instinctive need to be held and kept close. So, expect your baby to want to be held all the time, either by you or by Daddy, or grandma or grandpa, or, well, anyone really, as long as they are warm and have a comforting heartbeat!
But don’t expect to feed your baby every 3-4 hours and then change them and put them down and walk away. You are confusing them with a Baby Annabel doll…… ☺
4. Bad Advice.
“You’ll spoil that baby”
“Your milk isn’t [good] enough”
“S/he’ll be more settled on formula”
“Feed 10 minutes from each boob, no more”
“You have to drink milk to make milk”
“You must eat extra healthy now, or your milk will be poor quality”
“Routine, routine, routine…….”
I’m sure you’ve already heard some of these, and will undoubtedly hear others too. You’ll know if it’s garbage because it’ll go against your instincts and sound ridiculous!
5. Nipple Confusion.
Caused by dummies and bottles. http://www.breastfeeding.com/all_about/all_about_confusion.html
“What is Nipple Confusion? It is a problem that arises when a breastfed baby is given an artificial (rubber or silicon) nipple and must try to learn to nurse both from his mother’s breast and the bottle nipple. While seemingly similar, these two feeding methods require completely different mouth and tongue motions and swallowing skills.
In breastfeeding, the baby needs to take as much of the nipple and areola into his mouth as possible to ‘pump’ the milk from the milk ducts. In bottle feeding, he uses his lips to grip the tip of an artificial nipple. Some nipples do better to imitate a natural breast, but none are quiet the same.”
So, now you know what not to do, what not to expect and what advice to not listen to! I hope it helps.
You can find Jehefinner on twitter. She is a fantastic breastfeeding momma and a wonderful person. She describes herself as a “NHS Employee, coeliac, mother, sling-wearing, lactivist breastfeeder, cook, coffee lover, Nestle boycotter, Green & Blacks fanatic, lunatic and geek-chick”