Saturday, February 09, 2008


There’s no milk so uniquely and beautifully right for a baby as his mother’s own milk. Yet we so readily find reasons to undervalue the breastfeeding bond.

There’s no way so uniquely and beautifully right to transfer the milk from mother to child than the simple act of nursing at the mother’s breast. Yet, we so readily reach for gadgets and concoctions that approximate breastfeeding in a crude and incomplete way.

Many expectant couples say “we want to breastfeed if we can.” Of course! To my mind the “if” in that statement has the same level of uncertainty as “we want to conceive a baby by our own efforts if we can”, or “we want to breathe unassisted if we can”. The other option is unlikely, and should be avoided if possible.

Yet so many new mothers, with babies only a couple of days old, are convinced that they are unable to meet the needs of their babies, and resort to bottle feeding for some or all feeds. There’s no single reason for failure and discouragement at breastfeeding. Babies are all individuals, with individual strengths and capacities. Mothers are a diverse group, physically, emotionally, and relationally. The relationships each mother has with her partner and her family and friends has great bearing on her ongoing choices and decisions.

We know some of the events that can lead to poor breastfeeding outcomes. These include separation of mother and babe in the early hours and days of life; use of formula, teats and dummies; imposing routines of time or frequency; and giving conflicting advice to new mothers. Yet some mothers who experience some or all of these adverse situations go on to breastfeed beautifully for extended periods, while others who face only the most minor challenges will easily relinquish their breastfeeding relationship.

Sally, who is expecting her second child, told me with pride that she breastfed her little girl Molly for two and a half years. She told me how, when the family moved for six months to a Pacific island, the indigenous grandmothers all congratulated her on breastfeeding Molly who was then a toddler. The grandmothers told her that’s what they had done. Their daughters are not breastfeeding – they have accepted the globalised baby formula sold at the supermarket.

Sally was not well when Molly was born by elective caesarean. Molly developed ‘wet lung’, a serious respiratory distress, and was quickly taken to the nursery where her oxygen levels were monitored in a plastic ‘isolette’ box. Molly’s first feeds were formula. It wasn’t until several days later when Molly began breastfeeding. She had to learn how to suckle from Sally’s breast rather than a firm silicone teat that was thrust over her tongue. Sally had to learn to trust her own intuitive knowledge: her baby’s behaviour, and the tension of her breasts, rather than the number of millilitres in a bottle, in knowing that Molly had had enough.

The challenges that are experienced in breastfeeding are no less complex than any other significant life event. Just as labour and birth can be protected within the healthy natural processes for most women, most mothers and babies are able to make the transition from placental feeding to breast feeding without medical intervention.

Yet the reality of our maternity world today is that most mothers will experience a cocktail of drugs, and a complex set of medical interventions concurrent with giving birth. Most mother-baby bonding will also be complicated by hospital processes and medical interferences. By the end of the first week, when most are at home, some are happy and feeding well, while many are not far from weaning.

Understanding breastfeeding is best done when we consider what the baby feels and thinks about it.

A baby at one week of age, who has only ever suckled from her mother’s breast, is becoming very confident in the process. She knows that when she is hungry she is taken into her mother’s arms, and instinctively seeks the nipple, smells the milk, opens her mouth wide, and sucks strongly. After a short time the milk flows quickly and she has to concentrate to coordinate the work of her tongue, jaw, and swallowing mechanisms. If the milk let down begins and she is not well attached, she will come off and quickly seek a better attachment, knowing that the milk is there.

Another baby, also one week of age, whose experiences have included several different people providing different forms of nourishment in different receptacles may not yet recognise his mother’s breast as the place where his hunger is relieved and he feels exquisitely peaceful. His attempts at the breast have resulted in less than satisfactory feeding, and his mother’s nipples have been squashed, blistered, and grazed, and are very sore. So when this little fellow wakes up hungry it might be his dad or his granny who awkwardly manages a bottle with his mother’s milk in it, while mummy tries valiantly to extract milk from her swollen breasts. The milk doesn’t come, and baby is still hungry, so a bottle of formula is prepared. Baby responds thankfully, and sleeps for three hours.

The challenge to help this mother and baby establish not only breastfeeding, but also restore normal bonding processes, is a much greater one that experienced by his little cousin who has taken every feed from her mother’s breast, and is now thriving on an abundance of the liquid gold.

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