Tuesday, June 19, 2007

Nurture and nourishment of the newborn baby

A baby who enters the world without complication or medication, and who is held skin to skin by her mother immediately after birth will seek the mother’s breast in a way that is truly instinctive. We know that newborn mammals also do this – kittens with closed eyes; lambs on wobbly legs; and even tiny kangaroo babies climbing from the mother’s vaginal opening to the relatively distant pouch.

Babies who are born after surgery or strong medication may be delayed, but will, if given the opportunity and good support, act in the same instinctive way when they are able.

The Western ‘traditions’ of baby care that have prevailed during our lifetime include wrapping of the baby, separation of mother and baby, washing away birth fluids, and imposed routines in feeding, whether at the breast or artificially. As recently as the1990s researchers were able to publish papers and demonstrate to the professional community that the behaviours of a normal, unmedicated infant at birth are very similar to that of other mammals. Newborn babies who are skin to skin with the mother immediately after birth will open their eyes, lick and salivate, put a fist to their mouth and make rooting movements, then move in a deliberate way towards the breast, and work until they have achieved a strong attachment over the nipple and surrounding breast tissue (areola). They then begin a period of suckling, drawing strongly on the mother’s wonderful colostrum, and will, after a couple of hours of breastfeeding, usually fall into a restful sleep.

The healthy newborn baby quickly learns that her mother is the source of nourishment and nurture. If there has been separation at birth, such as in situations where mother or baby need special medical care, the instinctive (non-learned) patterns of behaviour can be re-triggered when mother and baby are well and able to be together. The early instinctive behaviours can be seen in a quiet, unhurried, softly lit environment, where the naked baby and mother come together. This strategy is often used by midwives and lactation consultants when a baby is having difficulty achieving effective breast feeding – a situation that is often the consequence of separation or drugs used in labour. The mother may rest quietly in a deep warm bath, with her baby on her chest. The baby will rest initially, then follow the distinct pattern of breast-seeking behaviours described above.

The message that ‘breast is best’ is well accepted, in theory at least, by expectant parents today. Very few will make a choice to against breastfeeding prior to the birth of their babies. Despite the knowledge that a mother’s own milk is unique and important for the human infant, many will have resorted to using some artificial feeds by the end of the first week, and weaned their babies in the early months. Breastfeeding is learnt by both mother and baby in the early weeks. When they receive appropriate support and expert advice, whatever early difficulties that are experienced can be overcome.

Breastfeeding, although natural, is not simple. There are many subtle physical and psychological factors in both mother and baby that can influence success. Once confidence in breastfeeding has been compromised in either mother or baby it can be quickly lost.

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