I support a lot of women to find their way through personal and political gunk and reach a point where they can birth their babies in nice simple births.As the end of pregnancy draws near I encourage women to start thinking about how they’re going to manage the early stages of the new breastfeeding relationship that’s coming soon.
For some of us it’s relatively simple because we’ve done it before, no particular drama, just boob till the kid starts high school or driving, whichever comes first.* Sadly for many women breastfeeding is complex, painful and difficult and this is largely due to the appalling lack of support, direct undermining of normal infant feeding and our obstetric birth culture which bears a huge responsibility for the lack of breastfeeding in Australia.
Recovering from previous breastfeeding experiences gone awry is vital to providing ourselves and our babies with the relationship we deserve. Many women also need to unpack their family’s mythology around birth and breastfeeding in order to locate obstacles we all unknowingly carry within ourselves. First time breastfeeders, or those with many children, can often benefit from working on this stuff.
Breastfeeding is far more than a delivery system for nutrition and antibodies. It is the way that babies relate to the world, and the security children carry with them. Every time my four year old breastfeeds to sleep she is doing what she has done since her first day earthside and that emotional connection cannot be sufficiently emphasised.
Breasts are the easiest parenting tool you will ever own so use liberally and wisely. They aid sleep because babies are meant to breastfeed to sleep. They bring calm to distressed, hurt or ill children. They bring relaxation to women who are infused with oxytocin for years on end. They provide free, instantly, constantly, ongoing medicinal, nutritional, emotional support to babies and children. You can’t actually buy anything that even comes to close to that in any way.
While our society would have us believe that the number of women who can breastfeed is very small, the logical reality is that the vast majority of women and babies are perfectly suited to establishing and maintaining a breastfeeding relationship over a number of years. Humans have managed to feed their young for some thousands of years now and just as evolution has created some pretty clever bodily functions we unthinkingly accept like breathing and elimination, so too lactation is just another normal capability of women’s bodies; nothing special just what is needed to feed human babies.
Some simple things I’ve observed as helpful to creating, sustaining and maintaining fullterm breastfeeding are easy to come by and can make the world of difference to a motherbaby dyad in an anti-breastfeeding world.
1. When you’re pregnant, find yourself a breastfeeding support group.
It is vital to make friends with women who breastfeed fullterm, who view breastfeeding as normal, can offer you support after your baby is born and won’t be strangers since you already know them. Most of us never see breastfeeding, our families have lost our breastfeeding culture along with our birthing culture and we seriously believe that we come from mothers who were defective and unable to breastfeed us. This does not set up an environment where normal infant feeding can be nurtured and maintained. Seeing breastfeeding helps us learn how to breastfeed.
Once upon a Nestle-free time, we would have grown up seeing breastfeeding, we might even have remembered breastfeeding as children ourselves. Most of us don’t have that kind of memory but we can help ourselves along by seeing lots of women with differently shaped breasts breastfeeding babies and children whose styles of breastfeeding might vary immensely. If the breasts you see around you were unable to breastfeed, evolution would have bred them out of us millenia ago. Just like every woman here is a tribute to the birthing body her ancestors perfected so too are her breasts. Your breasts come from a long line of grandmothers who breastfed when that was what was normal and susbstitutes had not yet been invented. Large or small breasts, inverted nipples, flat nipples, large nipples, every breast can breastfeed. In rare cases insufficient breast tissue develops during puberty but even this is not a barrier to breastfeeding, it simply requires more planning, community and commitment.
Partners are also vital to breastfeeding and regular exposure to breastfeeding, unpacking belief systems around breasts, sexuality and parenting are going to be beneficial to the quality of support partners need to provide. We are all products of the anti-breastfeeding world, we have all imbibed myths and outright lies from marketing. Establishing breastfeeding needs both parents to be committed to it and the non-lactating partner needs to increase their level of responsibility around parenting other children and household maintenance when babies are born. Normal physiological birth makes this easier too since caring for women and babies after caesarean surgery is far more demanding than postbirth support when a woman has had a beautiful and simple birth.
2. Give birth at home.
Hospitals aren’t only the absolute opposite of everything needed for a normal physiological birth, they are also the exact opposite of what babies and women need to establish breastfeeding. Just as breastfeeding is the normal way to feed infants, normal physiological birth is the normal way for an infant (or two or more) to leave the mother’s womb. Anything else puts up potential barriers to breastfeeding. The simple fact of shift change directly undermines breastfeeding as more and more staff come by with advice and suggestions few of which will be helpful to you coming from their obstetric paradigm.
Babies in hospitals are often induced and are thus premature which means they can struggle to breastfeed. To induce a baby means she is born a drugged baby from the syntocinon, pethidine and/or the epidural involved. The drugs all come with saline drips and major effects on women’s bodies which lead to huge amounts of fluid being retained and breasts which are swollen and difficult for babies to latch onto. So not only is the baby drugged, but the breast is a beachball the kid can’t latch onto.
It is normal for mothers and babies to be separated after caesarean surgery (and many obstetric births which included vaginal involvement) and again this is a severe potential disruption to breastfeeding commencing. A baby who has then been drugged, taken from the womb prematurely and then separated from her mother at birth is most likely going to struggle to breastfeed. This is unsurprising and it’s why birthing at home where your baby will be born to her own timetable, without drugs, trauma or separation is pretty obviously the way to really support the commencement of a breastfeeding relationship.
We can talk all that stuff about skin on skin after caesarean surgery, which is a popular discussion topic lately but in reality if you’re having skin to skin after your surgery are you sure your surgery was warranted? Remember a minimum of one in three babies will experience caesarean surgery. Add to this that homebirthing families are generally families who support breastfeeding and could well be the best possible group to find for my number one tip, and you’ve got every base covered for creating the most likely environment for breastfeeding to kick off drama-free.
In the unlikely event of a woman or baby needing intervention you can mitigate the effects with these basic points anyway. Support for pumping, maintaining a supply and daily life will be forthcoming from that group you find to support you while pregnant.
Breastfeeding, like birth, is an odds game and there are no guarantees of anything. We do however know what works to directly oppose breastfeeding so removing that gives the motherbaby dyad the best possible chance!
3. Debrief, unpack and understand your previous breastfeeding experiences as well as your family’s beliefs around breastfeeding.
Most babies in Australia are weaned very young and it’s not because women don’t want to breastfeed, it’s because everything in our system is set up to thwart even determined women in their desire to simply feed their baby the normal way for humans to feed.
Most women whose breastfeeding relationships are ended prematurely have grief, anger and distress around it which is unsurprising. This is usually packaged up and given back to us as the “guilt myth” which is really about our society’s discomfort with women’s anger but also because it makes the “failure” to breastfeed solely about the woman, not the system which failed her and her baby.
Understanding how breastfeeding really works, the factors which influence our capacity to breastfeed, looking at our family history and culture around breastfeeding, honouring the grief we feel, working out what responsibility is ours and what responsibility should be held by the obstetric surgeon, MCHN, GP, hospital staff, local pharmacist or any other passing underminer, will all help work out what went wrong and thus what can be avoided in future. Very few medical people have any idea about breastfeeding and are best avoided. MCHNs are particularly attuned to promoting artificial baby milk and all the practices which undermine breastfeeding so don’t go to any.
Examine your feelings about breasts, breastfeeding, the idea that your breasts will be more than decorative and sexual. This can be very challenging for some women and survivors of sexual assault or abuse can find they have complex feelings around intimacy and breasts and children. Support is always available but as above, best accessed before the baby is born. There will always be left field things like tongue tie, vasospasm, hypoplastic breasts or other stuff which is no one’s fault and which we can only manage when presented with them.
Knowing what to avoid and what to embrace is key. Again that group you need to find while pregnant will be vital to this.
4. Accept no samples, do not purchase artificial baby milk, dummies, sterilisers.
If anyone gives you anything like this thinking they’re being helpful, stow them safely in the garbage bin where they don’t do too much harm.Worry about landfill another time. Anything readily available that denormalises breastfeeding as the way to feed a baby is undermining you from the get go. Don’t do it to yourself. If you do struggle at some point with breastfeeding, people around you commonly try to alleviate their distress by offering you the chance to stop breastfeeding. This does not work in the longterm.
The beautifully generous supply of milk when lactation begins can be easily managed with a hand pump or by learning to hand express. These can be borrowed from the women you know who are your breastfeeding support network and you only need to use them for the first week in most cases just to reduce the engorgement and let the babe latch on comfortably. The baby will regulate the supply she requires so long as you feed the babe when she needs feeding.
Establishing breastfeeding can take days, weeks or even months and it simply isn’t helpful to have that kind of substandard caper in your home. A relationship of such importance to health and wellbeing for women and babies which can last up to seven years is worth spending some time developing even if it takes a few months to really get the hang of it. The effect of not breastfeeding is with us for life in all sorts of ways so committing to it means you never have to live with a lifetime of regret.
5. Cosleep, babywear, feed the babe when she needs feeding, basically just parent the kid.
Some modern experiments around baby care have failed parents and children dismally. They have however made very wealthy those who produce cots, baskets, artificial baby milk, dummies, nightlights, soothing music tapes, prams, rocking chairs, watches, clocks, video monitors, heart monitors, breathing monitors, stupid creepy hand things, psychotherapy, and so on and so forth. One of the fastest ways to make breastfeeding difficult is to put yourself in a different room from the baby to sleep. You wake up to a cry, stumble in, grab the kid, nod off in the expensive rocking chair then stand up and try to pat an unwilling baby back to sleep who cries as soon as you put them down because they’re smarter than us and trying to tell us that we need them in our bed.Put the baby in the bed is the only parenting advice my mother ever gave me. It works! The baby snuffles, or latches themselves on, you feed, you both doze, you go back to sleep.You can learn to breastfeed lying down without too much trouble particularly if you ask those breastfeeding women in point one for some help. I’ve laid on many a floor to show many a woman how it’s done.
It always irritates me that I have to spell this out since “feed the baby when she needs feeding” seems only logical. Basic baby care means human babies actually need to have nutrition readily available 24 hours a day from birth in the same manner they did in the womb. They don’t leave the comfort of constant nutrition via the placenta and come into the world programmed to three meals and two snacks a day. They come out with little bodies which need the exact same nourishment and luckily, breasts provide it. So let the baby feed when she needs to feed, don’t make a baby go hungry with the current fad for timing feeds. Do you know anyone who eats four hourly for 15 minutes per course? No, neither do I, least of all someone who weighs 4 kilos and has only just learnt to breathe and suckle. You can only feed a baby 24 hours a day if you sleep together, anything else is going to send you into a dribbling heap and ruin your breastfeeding relationship.
Wear your baby when she’s not in bed with you. Nothing is more portable than a breastfed sling baby! Baby on the inside, becomes baby on the outside, no difference except the funky fabric wrap contains them instead of your womb.You become in tune with one another, you can breastfeed in most slings and that community you located while pregnancy will have a heap of women experienced in babywearing while breastfeeding, all eager to assist you.
You can’t breastfeed a baby in a pram without unearthly flexibility and remarkably large breasts so it’s more practical to bring the babe to the breast in a simple carrier of some kind. Cheaper and more convenient than a huge pram anyway. Babies facing away from parents in prams are going to feel abandoned so simply keeping them close in a carrier solves that kind of problem before it becomes a problem.
Expensive breastfeeding clothing has swept the market in recent years but honestly a shelf singlet is cheap, effective, keeps your tummy warm in winter, comes in many colours, and is just as effective. No need to spend money on that stuff, just make sure your tops have stretch in them so your breasts fit out the top of them easily. If you’re going to be tandem feeding, make sure they’re very stretchy so you can get both breasts out when needed.
This is by no means an exhaustive list of what enables breastfeeding nor have I tried to tackle some of the common problems which plague artificial baby milk-normalised cultures like our own. Back to basics understanding of breastfeeding however is that it really is at heart a remarkably simple system of providing so much to babies and women via so simple a method as suckling. Setting ourselves up to breastfeed rather than “see how it goes” “hoping” or feeling fearful can make the difference in both how we manage breastfeeding but also importantly, our ability to seek help should we need it.
* Remember you will be cosleeping till at least university so this is no problem.
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Full kudos to Giving Birth With Confidence for this link fest section of my post. Thank you for a beautiful carnival!
ETA.
By an odd coincidence, this post came out at the same time as the Healthy Birth Carnival so there are a heap of other blog entries out now underscoring the practices which detract from breastfeeding.
Why does keeping moms and babies together after birth matter? Because separating moms and babies is harmful.
Kimmelin Hull at Writing My Way Through Motherhood and Beyond writes:
The research on this issue is crystal clear: babies do better in the first minutes, hours and days, the more time they spend in skin-to-skin contact with their mothers. Their breathing and heart rates remain more stable. Their body temperatures fluctuate less. Ditto for their blood sugar levels. They cry less and they nurse and sleep better, too.”
Danielle at Momotics also reviews the harms of mother-infant separation and suggests that her baby’s 30 hour stay in the NICU for management of blood sugar instability may have been preventable if the hospital had allowed for skin-to-skin contact instead of routine separation. She also points out that skin-to-skin contact exposes newborns to normal bacteria on the mother, which can protect them from getting sick from hospital-acquired bacteria.
Research aside, what about common sense? From the baby’s perspective, the “maternal environment” represents a familiar landscape in which to feel safe and avoid distress (which has well-documented physiological effects.)
Danielle at Informed Parenting describes the moments after birth from the perspective of the baby held skin-to-skin:
Then suddenly he is enveloped in warmth, laying wet and slippery on his mothers chest. He hears it- the beating of his mothers heart. He hears her voice, so clearly for the first time. He knows what he needs and he seeks out that attachment, the physical bond to tie them back together. Little toes flex and dig into his mother soft belly as he wiggles and squirms forward, his little mouth open and questing. The sound of her voice draws him forward. Her arms support him in his journey. In a feat of strength and coordination that is truly amazing he reaches his goal and re-establishes their physical bond. As he suckles her nipple, drops of liquid gold land on his tongue.
Mamapoekie at Authentic Parenting describes a similar scenario, and then contrasts it with the far more common scenario:
You are being pulled away from the one smell and feel you knew to again another entirely different setting. They prick you and it hurts and they rub you down and put stuff in your eyes, it stings even more than the light! You are starting to feel very desperate, very helpless.
boheime at Living Peacefully with Children believes that both birth and bonding are easiest when the mother feels well cared for, and can simply be with her baby to find the right rhythm. She relies on her very willing husband as her primary support for both.
With the birth of each child, he has taken off 2-3 weeks from work in order to cook, clean, and help out however I need him. It’s because of his support that I have been able to focus on getting to know each of our children, establish breastfeeding with them, and not feel as though the entire house has fallen apart.
With so many documented harms from mother-infant separation, not to mention the primal urge for mothers to hold their babies, routine separation of mothers and babies is a mainstay of modern obstetrics, and may give rise to the epidemic of breastfeeding problems.
Sheridan at the Enjoy Birth Blog remarked that her students who have given birth before are among the most surprised that mothers are “allowed” to have their babies with them right after birth. She writes:
It is shocking to me how many moms who are taking my Hypnobabies class for the 3rd or 4th baby and they are amazed that they have the option of keeping the baby on them for an hour or two.
After participating in many hospital births, Carol van der Woude at Aliisa’s Letter also had an awakening about how unnecessary hospital routine are. She describes the first time she saw a home birth:
My wonder at the miracle of birth was renewed. I watched as the baby emerged and the umbilical cord was left intact. The pulsating cord delivered oxygen to the baby as he made the transition to life outside the womb. The baby was placed on the mother’s chest, skin to skin, for warmth. The infant was comforted and stimulated in his mother’s arms.
Lamaze educator Nicole VanWoudenberg who blogs at A Little Bit of This and a Little Bit of That was in fact one of those women who didn’t know about the importance of immediate and close contact after birth until after she had had several babies. She describes her first and last births. After her first birth:
They cleaned her up, weighed and measured her, gave her the vitamin K shot, the eye ointment and whatever else, I was stitched up and approximately 45 minutes later, I got my burrito-baby. Seriously, she was diapered and all wrapped up in towels!! I did not know better, and left her like that while “bonding” with her. Did I have breastfeeding issues? Absolutely. Are the two connected? Absolutely.
For her fourth baby, born at home, she recalls:
I didn’t wait 45 minutes to receive my son. I birthed him and brought him up to my chest, for skin to skin snuggling myself. And there he stayed while we marveled at the wonder of birth, and his appearance! I only let him go while I got out of the pool to birth my placenta. As soon as I was settled on the couch, he was back in my arms, skin to skin – starting to nurse. He breastfed the best, and the longest of all four of my children. Are these two things connected? Absolutely.
Molly at Talk Birth discusses the Birth-Breastfeeding Continuum in her post. She writes:
New mothers, and those who help them, are often left wondering, “Where did breastfeeding go wrong?” All too often the answer is, “during labor and birth.” Interventions during the birthing process are an often overlooked answer to the mystery of how breastfeeding becomes derailed.
Kmom at The Well Rounded Mama reviewed the research surrounding “Baby-Friendly” practices, points to a study that reported only 8% of babies actually experience the six Baby-Friendly practices, and then examines breastfeeding issues in women of size. She writes:
The role of aggressive birth interventions in the lower rate of breastfeeding among obese women typically goes conveniently unexamined in the research. Breastfeeding failure is blamed solely on fatness, when in fact, the high level of interventions in obese pregnancies and births may also play a significant role.
Laura Keegen, author of Breastfeeding with Comfort and Joy writes about the birth stories of women she works with who encounter breastfeeding problems.
“A common theme in all of these stories has been the shock from the denial of contact with their babies or the importance of having that yearned-for close contact at birth,” and asks, “How many breastfeeding problems could be prevented if we facilitated this close contact at birth?”
Full kudos to Giving Birth With Confidence for this link fest section of my post. Thank you for a beautiful carnival!
ETA: Another item in an Australian newspaper pointing to the experience of breastfeeding being as a result of support during pregnancy, birth and beyond.
Does a lover really have first claim on breasts?
TweetI was unable to breast-feed my first son for several reasons.
First, he was taken away from me at birth and fed formula down a tube in his nose for 24 hours, although no one consulted me on the procedure.
Then the hospital failed to diagnose a severe tongue-tie (where the bit of tissue that roots the tongue to the floor of the mouth is over-extended, literally “tying” the tongue, meaning the baby cannot latch on to the nipple).
Second time round, I hired an independent midwife for a home birth and she had my son on the breast within 40 minutes, then gave me intense breast-feeding support for the next month, which I needed.
It made me realise how chronically ill-equipped most hospitals are to offer this kind of back-up, and how inevitable it is that many women, unsupported, will cease the effort. I found breast-feeding painful, awkward and difficult at first – yet ultimately it was one of the most rewarding experiences of my life.
My motto exactly. Wish I could spell it out as well as you can!
Oh thanks! I’m really tired of lactavists being so apologetic for simply supporting normal feeding of human infants and so many of us are squeamish about linking breastfeeding to birth despite the obvious evidence _and_ parallels. It’s just normal, tain’t spesh, and certainly isn’t “best”! Just normal and not substandard like ABM.
What an awesome resource! Such simple advice, it’s a tragedy many women never hear it. Sharing this link!
Thanks, Dionna! Great to see you dropping by. *kotc*
Hi Janet – I found this article really interesting – so much of it resonates with my own experiences of two very different pregnancies and births – and breastfeeders – but there were a few new things I learned, which is great. However a few sentences just jarred with me and this was one: “We can talk all that stuff about skin on skin after caesarean surgery, which is a popular discussion topic lately but in reality if you’re having skin to skin after your surgery you probably didn’t need the surgery since neither of you are sick. Got that?” Can you please clarify? My son was born by emergency caesar due to being in great distress so I am struggling to understand this statement. Thank you for your time!
Hi Katherine, thanks for dropping in and for your comments. I tried to be general in my piece and I’m glad that it resonated with you.
I’m sorry to hear of your surgery, it can be an intense experience.
What I’m getting at relates to a few things. First off, most people who aren’t obstetric surgeons agree that the rate of caesarean in the western world is ludicrously high. This is for many reasons but mostly because birth in Australia is now controlled by obstetric surgeons to whom surgery is normal and desirable. In Australia the top reasons for caesarean are not medical but iatrogenic, owing to the surgical monopoly over birth. Most common reasons are twins, breech, prior caesarean and “failure to progress” which most commonly occurs after induction on dates alone with no medical indication. This is known as “failure to wait” outside of hospitals. I don’t know why your caesarean occurred obviously, but these are the most common reasons for surgery in Australia according to the national perinatal data.
As I said, none of these are medical indications for caesarean but caused by interference in birth, lack of understanding of birth and because hospitals value time and motion over evidence based care which values the motherbaby dyad before all else.
One response of those who work with birthing women is to say “Lots of caesareans are occurring so this means we’d better work on making them nicer for women and babies by encouraging skin on skin after surgery.” While I salute this desire to improve surgical experiences for women I see a deeper problem with that argument.
For me, it is more important to reduce the number of caesareans to those which are only performed in actual dire, genuine emergencies. There are a few booked surgeries ie non-emergent surgeries where babies are more likely to be able to be skin on skin with their mothers in theatre, for example, complete placenta praevia. Of course the risks of caesarean to babies make it always touch and go whether or not this is possible but most definitely it should always occur when the health of the woman and baby allow it. The current rise in maternal mortality in the US shows what happens when the number of lifesaving caesareans becomes overpowered by unnecessary caesareans which therefore cause more harm than they prevent.
My problem is that in trying to improve the caesarean experience, when most caesareans can be shown to be unnecessary, we normalise caesarean surgery further in our communities, offer women an illusion of control and allow surgeons to keep on cutting women who don’t actually need their skillset. Caesareans should only occur when the risk of the caesarean is less to the woman and baby than continuing in a labour process towards vaginal birth. The risks of caesarean surgery are so high that this is a rare occurrence in nature.
It’s not much skin off a surgeon’s nose to have to provide a little humanised care when they’re already getting their way having put the women into theatre in the first place whether she needs it or not.
So when I hear “emergency caesarean then we had skin to skin in theatre” my spidey senses tingle. Occasionally this may be a good call on surgery. In the event where a baby has chosen their birthday by kicking off a spontaneous labour and is not premature, and where for whatever medical reason the surgery has commenced, there are no health problems in mother and baby thus skin on skin is possible.
For most women “emergency” doesn’t mean “lifesaving”, it means “I got timed out by my hospital who told me my baby was in distress and had to be cut out immediately” but obviously no hospital is going to tell a woman that because they need to have a semblance of justifiable reasons to perform major abdominal surgery on women, at least on paper. The language obstetric surgeons use does rather make opaque the reality of why caesareans occur since “emergency” only means “after labour has commenced” not actually “lifesaving, totally medically necessary” and is only in order to differentiate it from what’s called “no labour” in the perinatal data, the code for “booked surgery”.
We encourage women to be happy with crumbs and to accept the status quo when we console ourselves by saying “At least you got skin on skin.” despite the risks to the woman’s life both in surgery and later from PTSD and depression. The greatest cause of maternal death in Australia is suicide, after all. Avoiding caesarean avoids preventable maternal deaths since PPH is a major risk of caesarean and so is PTSD.
Obviously I have no beef with women nor with the activists working on humanising birth although I do have a deep sadness that we struggle with such might to improve something so diametrically opposed to birth when there are perfectly normal places to give birth which don’t have such risks attached: our homes.
I hope that clarifies for you my somewhat provocative comment and that you and your son are healing well. My son experienced significant gut damage as a result of our surgery and the ripple effect that caesarean surgery creates and it is a longterm process of helping him to heal. He will be seven in a few months and still experiencing the damage every day.
I wish you clarity, peace and beautiful birthing in future.
Thank you for your reply. Yes, on the whole I agree. My son was born early due to severe pre-eclampsia and his heart was stopping/plummeting with contractions, so they did an emergency caesar and found the cord tightly wrapped around him. For us I believe it was necessary and I did manage to have a much better (vbac) experience second time around. We didn’t get skin on skin immediately (with my son) – but I wish I had known a bit more about it and done just that! I tried it down the track (a lot) but it still took a concerted effort (or bloody mindedness) on my part to breastfeed successfully! I so agree that the breastfeeding relationship starts before our babies are born – and so often it is “the system” that undermines us and then makes us feel failures…
PE can be dangerous to women indeed. It’s certainly a rare but serious occurrence. Congratulations on achieving and maintaining a breastfeeding relationship. It’s hard enough in the system let alone with illness compromising the kick off. Thank you for sharing. It is important to remember that breastfeeding is a resilient process and can be managed even in such difficult circumstances. Support, support, support, so critical to parenting in every way!
Great post, Janet, thanks! Have shared it on FB, such sound advice, all of which I benefited from greatly over two years ago now
How lovely to hear.
Thanks for dropping in and for the link!