Imagine this: you stumble across a bicycle. You’ve never been on one or seen someone ride, but you’ve heard about them and kind of know what they’re for. It looks self-explanatory, so you figure you’ll try it. How hard can it be? You climb on and attempt to pedal but fall over. You try again, yet you can’t seem to gain enough momentum before losing your balance. You’re determined; you can see it will have advantages if you can just get the hang of it! You’ve got scrapes and bruises, people shouting encouragement, others saying you’ll never do it, and then everyone giving advice on how to ride that’s contradictory and confusing. You work hard to finally start wobbling forward… but no one taught you steering, so you crash. You’ve had enough! You quit! Grief and depression set in; you think you’re a failure, riding bikes must not be for you, or so angry you feel no one should ever ride bikes!
That breastfeeding is easy and natural is one of the most prevalent and harmful myths where new motherhood is concerned. Many a mom has struggled and not sought help because of deep shame and guilt about having trouble with something that was supposed to happen naturally. New moms may also be unaware that trained, expert help may be available and could be beneficial. Unfortunately, there also appear to be racial and economic disparities in some areas of the country where moms might have no access to lactation care.
It is widely assumed babies are born knowing how to breastfeed and women just offer the breast and all is okay. I thought the same as a first-time mom—and I was a Neonatal Intensive Care and Labor and Delivery nurse at the time! Perhaps this assumption is why there was, and is, no breastfeeding training in the nursing school curriculum. My “failure” turned into my passion.
The truth is that babies are born with a set of behaviors that may allow many to find the breast and latch if they are placed skin-to-skin with mom immediately after delivery and not interrupted. There are nine sequential developmental stages that have been identified from birth to breast. Labor medications can potentially affect the newborn’s state and might impact their ability to progress through these stages, as well as hospital practices that delay skin-to-skin contact in favor of weighing the baby or separating them from the mom for initial care. Another factor at play may be staff or parents not allowing the baby the time to adapt, recover, and move through these behaviors, which is suggested to take approximately an hour.
Although sucking is a reflex in nearly all babies, the fingers, lips, tongues, toes, or even the umbilical cord they suck on while in the womb do not always translate into latching or coordinating sucking with swallowing and breathing. Some babies use their tongues incorrectly, tongue thrusting, curling/rolling their tongues, or not opening their mouths enough. Other babies have oral restrictions or ties preventing them from sealing the breast with their lips or moving their tongue correctly. Babies can have weak oral motor skills or experience physical and positional discomfort from birth, making latching more difficult. All of these challenges may be improved with specific interventions when recommended by a specialist.
Unless mothers attend class, they aren’t routinely taught what’s normal for a breastfed baby, how the breasts make milk, how to latch, or how to tell the baby is drinking and getting enough. Feeding questions such as how often, how long, and how much are commonly asked by moms. Babies aren’t always hungry when they cry, and a baby having trouble breastfeeding doesn’t signal that they “don’t want it.” The information moms do get regarding feeds often reflects a bottle-feeding culture and a measurement-driven society; normal for one is not necessarily normal for the other. Additional information about ways to tell a baby is getting enough is offered in a free .pdf on https://linktr.ee/freshsqueezedlactation. There’s also a paid mini-course in collaboration with Soothe Beginnings, which covers what might be considered normal and may offer ways to support or address low milk supply.
“Practice makes perfect” can only be helpful if the practice is correct and the information is accurate. The same assumption that breastfeeding magically happens, the same lack of information plaguing moms, may extend to physicians as well. No one taught them, either. Surprisingly, doctors often receive zero formal breastfeeding training in medical school. The information on infant nutrition they do receive frequently reflects a perceived bias towards artificial milk being presented as equal to or better than breast milk. Even doctors specializing in babies, such as the OB/GYN or pediatrician, may receive only minimal education during residency; on average, about three hours per year. Plus, much of the continuing education hours offered to them reportedly come from formula company-sponsored productions. Other unreliable sources can include family who may have had experiences from a generation that didn’t breastfeed or friends who tried but relay horror stories of trouble or early weaning.
Where are women to seek assistance? La Leche League may serve as a good community resource with local chapters of moms supporting other moms. There’s a National Breastfeeding Helpline available at 1-800-994-9662. WIC employs peer counselors and sometimes lactation consultants. There are Certified Breastfeeding Counselors (CBC) and the International Board Certified Lactation Consultant (IBCLC). The LC must meet the required education plus 500 or more training hours and then pass an exam. Many hospitals have started staffing lactation consultants, but there may be only one for the entire unit, as happened during my twenty-four-year tenure, and some of the most common problems tend to arise at home. So, ideally, moms might find it beneficial to take a prenatal breastfeeding class with one of these experts in preparation. She could establish a relationship with someone knowledgeable who might help support her through any challenges. Consider how elite athletes enlist a coach to hone their skills.
Published By: Aize Perez
