Tuesday, October 8, 2013

Breastfeeding 101: the beginner's guide...

I could write a book on breastfeeding but, for one, there are many excellent ones out there already. I have listed my favorites at the end of my book in the Resources section. And secondly, if you are expecting your first baby, or if you are expecting another baby and had difficulties breastfeeding the first, I would strongly urge you to read all you can and also sign up with your partner for a breastfeeding class. Mothers who are most successful usually have the support of their partner. Without that support it would be a constant struggle, and worry and fatigue are the two prime culprits that undermine successful breastfeeding and milk production.
           I also didn’t have all of the wonderful information, DVDs, YouTube videos or books that are available now when we were having our babies. I knew it would be difficult for the first 2 – 3 weeks but I was determined to do it. Yes, I had cracked bleeding nipples and chronic neck pain from leaning into my babies (whom I would lay flat on their backs on my lap) instead of bringing them to my breast. I also didn’t have a clue in 1980 that babies could latch on their own and actually do better if we let them lead this mother-baby dance. We didn’t have Boppy pillows, either. All of these things would have made it oh-so-much better, but we trusted that Nature had this thing all figured out, and we were gonna get the hang of it even if it killed us. Which it didn’t. I was lucky that the La Leche League was going full tilt by then, having started back in 1969, so I had a ready resource to call when I had questions or problems. They were wonderful and are still available today.
           In my breastfeeding classes I start out by saying that 1. I never owned a breast pump and 2. I never bought a nursing bra. I was able to nurse twins until they were past 2 and nursed 5 children in all, using exclusive breastfeeding to naturally space our children and as birth control. (See: Breastfeeding and Natural Child Spacing by Sheila Kippley.)
            What is important is that breastfeeding, whether you do it for 3 months or two years or more, creates the conditions necessary for bonding. Some moms cannot nurse at all, but what is critical is the skin-to-skin contact. Nature ensures that babies and mothers have that bonding time regularly throughout the day and night, every day until babies are mature enough to eat solids and venture off exploring further and further from mom, which both occur at about the same time, somewhere after 6 months or so. It is vital that whether you are holding a bottle or nursing that you are holding your baby close: Tummy to tummy, chest to chest, the nose and chin should touch the breast. Partners should also have regular skin to skin time every day with baby, too. And please never prop a bottle up and leave your baby in a crib to finish his feed on his own, especially during his feeding time. He cannot ‘talk’ to you while he is sucking, but he will be looking for your eyes to meet his which is just as important a bonding factor as cooing and getting a response from you. He cannot smell you, which is also a point of connection if he is drinking his bottle off somewhere else without you.

So, stop reading this right now, pull up a new tab, go into YOUTUBE and drop this in:  http://www.youtube.com/watch?v=SZ3QO-7h4YA  It is THE BEST breastfeeding ad yet!
I would add here too, that as tempting as it is to use your nursing time to catch up on the phone or to read a book, that you will actually miss the cues that your baby is sending out
            Again, there is a threshold somewhere between what is just enough of all the levels of all the factors of bonding needed for healthy development and what is simply too little and results in irreparable damage to the psyche and can never be repaired or fixed once it has passed that point below that limit. The ramifications may very well be the innumerable problems we see in our babies and young children today. 
            The cycle of life of animals in the wild can teach us that this sequence of events is required for successful survival to adulthood. The various facets of life must all fall into their proper place for growth and maturity. Without one or the other bonding factor as Nature intended and has flawlessly built in to all species of animals, yes, even us human animals, there is a disconnect that occurs, throwing the entire exquisitely designed system into chaos. We must trust this
sequence of events and allow them to be fully expressed at each stage of development as our children grow if we want them to ever reach their ultimate potential of wellness and happiness.
            Human and mammal babies alike use their breast time also for learning as they play. The touching and stroking that a baby does as he reaches out to his mother are not meaningless acts. He is learning that other people also feel and not only him. He learns here first that he can give pleasurable touch and not only receive it. Children who do not experience these early lessons often go through life without the empathy required that we should bring to all our relationships in life. They may even develop a conscience devoid of compassion as is being researched now in criminal minds. The disconnect could possibly be traced this far back into infancy.
            My own babies used nursing time to learn about other’s (mine) feelings of joy and pain. My baby boy twin bit me once and definitely registered that I reacted quite violently. The next time he tried it, he did so quite thoughtfully, maybe to visibly test my reaction. He slowly clamped his teeth on my nipple while looking directly into my eyes. It was definitely a learning moment. Of course I again quickly broke his suction and pulled him off my breast, voicing an unequivocal “NO!” He was actually smart enough by 7 months to learn what this meant. He had set up the experiment quite consciously (not with any malicious intent but just curiosity) and learned from it. I also found it curious that from about that same time he always got a foot up onto my other breast as if to ‘guard’ it from intruders whenever he nursed. He was protecting not only his milk supply but his access to me, or rather my undivided attention for him, literally perhaps because there were two of them and my attention was divided that they needed more cuddling and listening than my other three children seemed to need, both during their 3rd and 4th years especially. I could actually fend off squabbles and even tantrums by stopping what I was doing and literally sit down cross-legged on the kitchen floor taking one or the other onto my lap and wrap my arms around them, even if it was only for a couple of minutes, to listen to what they needed to tell me. His twin sister devised a repetitious kind of touching when she nursed. One little hand fit into my arm pit while her other hand stroked my upper lip under my nose. She would also watch my face and object if I became busy with one of the other kids and looked away from her.         
I observed that my babies could not multi-task when nursing. Either they could suck or listen to what I was saying or singing but usually not both at the same time. They did stop sucking when they wanted to concentrate on what I was saying and occasionally tried to repeat what I said, whether they had a mouth full of breast or not. I also want to mention that most parents worry if their baby was born prematurely or needed interventions at birth and were not allowed to bond immediately at birth and instead spent time in a NICU. Many children’s hospitals and neonatal intensive care units are doing very well nowadays in encouraging bonding.

Kangaroo time, when Mom or Dad have skin-to-skin time with their newborn is an important element in the newborn care plan. Singing, talking to and stroking premature babies is just as important as the antibiotics and surfactant medications given for underdeveloped lungs in newborns. Especially with tiny babies, remember that we are the only mammal that dresses our babies after they are born.  

Ruth, our other twin developed a stutter when she began to talk. I puzzled about this for quite a while. It was only after I began to stop what I was doing – cooking or cleaning usually – and would physically turn to her and look at her when she wanted to tell me something that it finally went away. It had something to do with my not fully engaging with her for enough moments during the day that was the cause.
Stop and consider: this moment at the breast seems to me the most bonding intensive time of any day, for they are not only eating, but their mouths (lips, tongue and cheeks) are completely engaged (tasting and touching) while at the same time they are smelling you without even thinking about it, hearing you, looking at you, and being carried or laying on you somehow. No other single activity intertwines all the factors of bonding. And if this occurs 8 – 12 or more times per day every day in the first 6 months and continues, though progressively less
often over the next 6 months, this appears to meet the threshold requirements needed for adequate bonding. The opposite would look something like this: feedings every 4 hours and not on demand would factor out to only about 6 times per 24-hour period. If the milk is in a bottle, more often than not especially after the newborn stage, the baby will be able to hold his bottle and not necessarily be in contact with a person, thus removing the voice, sight, hearing and touching interaction with a parent. The threshold contact times of each factor then goes from 100% engagement occurring 8 to 12 times per day for the first 6 months, and slowly leveling out over the subsequent months up to a year or more versus less than 5% of each of the 5 factors often not even once per day. Bedtime cuddling alone will not replace the numerous other periods of contact missed. And those cannot be replaced once lost.
A child’s sense of security is learned at the breast. Even baby animals will run and hide under a parent’s wings or body when threatened. Our human babies invariably run back to be enveloped in a parent’s arms when they have fallen or bumped or bruised something or their feelings are hurt. Even when they are older, children will climb into bed with their parents if they’ve had a nightmare or are afraid of a storm. Children whose parent(s) do not allow this are leaving children to somehow soothe or comfort themselves. Insecurities and phobias may well be the result of a fragile or unresolved attachment at this stage. Children will be the first to announce their declaration of independence, and not the other way around. If they have had a secure bond and are allowed to venture away from it at their own speed and not be rushed, and not be told they are now too old for this, they will be far more independent and confident than their peers who were literally pushed away from a protecting figure.

STAY TUNED... This and other stories will be appearing the book, Stone Age Babies in a Space Age World: Babies and Bonding in the 21st Century© pending by Stephanie Sorensen 

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