Saturday, January 14, 2012

Breastfeeding well from the start

1977, with my son Paul
Breastfeeding is PLAN A. 

Breastfeeding is what a woman's body expects to be doing, whether her mind agrees or not, and it's what a baby expects to be doing, from the start. Anything else is a variation from the biological, hormonally determined, norm. Anything else is a compromise, as far as the natural physiological processes are concerned.

Although breastfeeding is 'natural', it's not simple. For many women and babies, it's not easy. For many women, alternatives appear attractive.

Today I want to focus on breastfeeding well from the start. This is not possible for all mothers and babies, but it is possible for most. As with 'Plan A' in birth, 'Plan A' breastfeeding can best be achieved when the mother, the midwife, and all involved, accept and work in harmony with sensitive natural processes. As with 'Plan A' birth, 'Plan A' breastfeeding can be interferred with by a well-intentioned but misinformed person, resulting in distress for all and possibly long-term consequences.

The midwife who understands these truths will protect the mother-baby pair during pregnancy, labour and birth, anticipating the wonders and challenges that lie ahead; will support the woman and baby as they learn about and explore each other from the moment of birth; and guard the bond between mother and baby after birth, guiding and instructing the new mother only when the need arises.

The title of this post, 'breastfeeding well from the start', puts breastfeeding into the context of a continuum.  Breastfeeding is a relationship, not an act.  The same word, 'breastfeeding' describes what the baby is doing, and what the mother is doing.  Yet the actions taken by the two participants are very different.

Consider the breastfeeding continuum within the series of firsts:
. the first moment
... the first hour
..... the first day
....... the first week
......... the first month
.......... the first year

Breastfeeding well from the start is, like any other natural phenomenon, most likely to continue on the right track if it starts on the right track.  By this I mean, the mother and baby who are well at the onset of labour; who proceed spontaneously, without medical stimulants or emotional coaching or analgesia or anaesthesia to a normal birth; who experience the wonder of falling in love in the moments after birth, bringing with it a huge surge of the love hormone, oxytocin; enabling the mother to release her baby's placenta without excess blood loss, and enabling the baby to use his senses of sight, smell, taste and touch to search for the breast and achieve a deep attachment; suckle, and swallow the sweet, precious colostrum.  This is usually happening in the first hour after birth, before anyone else has held the newborn. 

The first hour quickly passes, and the first day unfolds.  Mother may pass the precious little person to the father, or another trusted family member, so that she is able to empty her bladder, and wash herself.  She needs to eat and drink, and rest.  Each time baby is alert, the instinctive actions of both mother and baby culminate in breastfeeding.  Baby goes to sleep, and mother can't because she is too high!

2011.  Bec and James (18mo)
The first day opens out into the first week.  Baby works strongly and confidently at the breast, and soon the breasts are swelling and producing a bountiful flow.  Baby's feeding and sleeping pattern changes, as does the colour of his stool.  Mother sleeps well between breastfeeds at night, and is quickly returning to strength.  She accepts the closeness of the relationship between herself and her child.  Someone asks "Do you feed your baby on demand?" and she has to think what that might mean.  Not really - her baby has never learnt to demand a feed.  She looks at her baby, or her baby looks at her, makes a sound or a movement of his mouth, and together they proceed with the most satisfying and beautiful work that either knows about.

And so it goes, through the first month, and the first year, or two, or ...



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