All mothers have an innate capacity to breastfeed regardless of having seen other mothers breastfeed when they were children, contact with other breastfeeding mothers, education, type of birth and other cultural-socio-economic factors.
Breastfeeding problems commonly originate in our cultural and strict breastfeeding practices, getting babies into routines early, putting a timer on breastfeeding, early and frequent mother-baby separation and putting the baby down a lot … and of course using upright positions. In BN positions mothers can easily see their baby and without spending any physical effort they gaze at their baby developing that special bond early. This releases instinctual mothering behaviours that can make breastfeeding feel easy and natural.
Mothers often worry they won’t know how to breastfeed and will do it wrong because they haven’t seen other mothers breastfeed. There is also a lot of scaremongering regarding the birth and ensuring baby has first feeds in the 1st hour following birth. Many mothers ‘think themselves’ into not breastfeeding for a variety of reasons. Whilst it can be helpful to see and socialise with breastfeeding mothers and breastfeed in the 1st hour following a natural vaginal birth, this doesn’t always happen. The BN research suggests that there are many windows of opportunity and the 1st hour after the birth is just one of these windows. Positions that prioritise maternal comfort and baby gazing are key in getting breastfeeding started.
Initiating breastfeeding is a right-brained activity of daily living.
The right-brain is the visual part of our brain, it responds better to images and forms our intuitive and creative being. Breastfeeding, like all acts of reproduction, is a reciprocal dance between 2 people; there are no rules or rights and wrongs, there is little thinking and analysis. It is often accompanied with a feel-good experience that makes us want to repeat the act. The more you do it, the quicker you figure it out and the better it becomes. Learning is a shared experience between mother and baby. Like other mammals, healthy human mothers with their healthy term babies normally do not require routine step-by-step breastfeeding instruction or management.
Breastfeeding feels different for everyone. Our anatomy is slightly different, one breast larger or pointing up or sideways, babies have square or pointy or receding chins… one size does not fit all and there is constant learning in how to breastfeed. Giving advice often confuses mothers and can disturb the breastfeeding relationship.
There is not one correct way to breastfeed.
We have been duped into believing there are just 2 or 3 breastfeeding positions. Mothers often sacrifice their comfort for the position that gets the milk to the baby. In fact, correct positioning varies from mother to mother. Correctness is a judgement and as heath care workers our role is to support mothers not judge them.
Prenatal Education
Exploring points of continuity from womb to world and hormonal links between pregnancy, birth and breastfeeding helps mothers get started with breastfeeding
Nothing can prepare a woman for a new baby, no matter if it’s a first or a fourth baby there is always a period of adjustment. Discussing the 5 points of continuity from fetus to neonate in the early breastfeeding days is useful information to share with mothers.
Breastfeeding is neither baby led nor mother led.
It is neither and it is both. Sometimes the mother takes the lead and other times the baby lets the mother know he isn’t quite finished. Intuitively mothers often take the lead in breastfeeding, for example demand feeding works 2-ways. If a mother is full with milk she can put baby to breast and ‘demand a feed’. However, health professionals have highlighted neonatal competency in breastfeeding while telling mothers they lack instincts. Time for mothers to reclaim what is rightfully theirs.
A baby does not need to be in an awake state to latch on and breastfeed.
This is probably the best kept secret! All mothers who breastfeed know that babies feed optimally asleep. In fact, the sleeping suckling baby is one of the most important points of continuity from womb to world. Did you know that the fetus sucks and swallows amniotic fluid every day of his life in a state of sleep. If there are problems with breastfeeding try holding your sleeping baby on your naked breast, this gives you ample time to adjust the latch or even hand express a little milk directly into your baby’s mouth to elicit a suck and a swallow. The first few days is a time of discovery and lots of trial and error; most healthy term babies are born with good fat stores. Breastfeeding during this time has little to do with hunger. Holding your sleeping baby at the breast, at the right address for long periods of time is probably the best way to condition little one’s feeding reflexes quickly and easily.
Cuddling, holding and body contact do not spoil newborn babies.
Cuddling, holding and body contact with a newborn baby feels good. It is another point of continuity from womb to world. Mothers spend 9 months in close contact with their babies and keeping the baby in arms helps with transitioning into life with a newborn. It also makes breastfeeding easier. It gives you the opportunity to discover your baby, to learn his cues quicker and get to know him; you can experiment with comfortable positions for holding and for feeding. The more you hold your baby the more he feels like he is yours; you build your confidence in having the final say. Cuddling and holding baby is really fun too and the benefits of keeping baby warm, reducing crying and earlier motor development should also be highlighted. Spoiling babies is an old fashioned idea and all it takes is a change in our vocabulary to create a change in our perceptions.
Understanding a baby’s reflex feeding cues makes breastfeeding easier.
The more you ‘try’ breastfeeding the better you get at it. Mothers often unconsciously stimulate their babies to trigger feeding. The stroking and focus on baby makes baby lick and knit the breast which lets the milk down and baby latches. When baby is in mothers arms, mothers respond quicker to the baby’s every movement however little.
When we talk about baby’s feeding reflexes it is worth talking about mother positions. In more traditional upright positions reflexes work against gravity and against breastfeeding with baby pecking at the mother, shaking his head left to right, breast boxing etc… When mothers are semi-reclined, baby’s feeding reflexes work with gravity maintaining baby at the breast and mothers often have their hands free to adjust the latch if needed or just have a cuppa!
Practice Statements
The primary aim of breastfeeding support is two-fold: reduce intervention and promote an environment conducive to the release of innate behaviors.
Human mothers and babies are versatile able to breastfeed in a variety of positions
Healthy mothers and babies should not normally be separated for a clinical assessment of well-being (baby being examined in basinet or cot with the mother in bed)
For the health professional BN is a method of observation of mother and baby behaviours. Assessment of mother and baby after birth is critical and can be done at a glance. We can gain information about mothers and babies just from listening and observing. Some things to look for are healthy skin colour, tone, symmetry in the baby, quiet alertness, normal breathing. What is most important in the assessment is knowing when it is necessary to stay with the mother and knowing when mothers need a little time to work things out for themselves. Generally a healthy mother and a healthy baby need very little intervention. All it takes is to make sure baby is in mother’s arms in an angle of recline that means she can comfortably gaze at her baby and look after his wellbeing, dim the lights and tiptoe out.
Breastfeeding pillows and other commercial support items or lactation devices should be used with caution. If the baby needed a pillow to breastfeed he would probably be born with it!
When you are with a mother having problems, knowing how to release reflexes and instincts is more effective than waiting for the baby to show interest and/or hunger
