​FASCINATING FACTLETS ABOUT BREASTFEEDING AND HUMAN BABIES
 
There’s a story I like to tell about breastfeeding and human babies and I like to divide it up into researched and known facts. Each little fact has a name so it helps you to remember them, but the main purpose of me bringing your attention to these facts is to ease your mind and help you to relax and enjoy your baby. When you understand how it was really meant to be, I find it is so much easier to accept and understand what your baby is doing, and why.
 
1.CARRY MAMMALS: We, as human beings, are classified as “Carry Mammals”. A “Carry Mammal” is a type of mammal who is supposed to carry their infants around and not put them down at any point. We are the same as the gorillas and the apes, who don’t make a nest for their babies and visit it every 3 or 4 hours, like a dog or a cat (“Nest Mammals”). We are not “Follow Mammals”, like a cow or a horse, whose young can walk from soon after birth so they can follow the mother around and feed when she lets them. If a gorilla or an ape made a nest for her tiny new baby and left it there for a while, she would surely come back to an empty nest!! On saying this, I am not suggesting that you carry your infant around twenty-four seven and never put it down….I am just saying that this baby is born EXPECTING to stay in your arms at all times.
 
2. NINE MONTHS IN AND NINE MONTHS OUT: We are actually born only half way through our gestational period. There’s research to suggest that it is nine months “in” and nine months “out” before the baby’s brain is fully developed and the infant is ready to be separated from its mother in any way. Apparently this happened when we stood up and became “erect” mammals. As we needed to become strong in our core and able to walk upright, our female pelvis became smaller than it was before when we were on all fours, and the baby’s brain, being the largest of all mammals, wouldn’t fit through any more. If you think about what a newborn human can do, it is very little compared to other animals. We know how to make our way to the breast, we know how to suck, and we know how to cry and alert our carers that we need help……and that’s about it!!
 
3.BORN TO GRAZE: Human infants are born EXPECTING to take very little milk, very often. When we are born our stomach is the size of a small marble. The first milk, or colostrum, comes in droplets. As the volume of milk increases over the next days and weeks, so does the capacity of the baby’s stomach, but still, the breastfed baby will stop feeding when it is full. It is NORMAL for a breastfed baby to wake and feed 8 to 12 times in 24 hours. This startles a lot of parents and sounds like hard work but if you relax, understand that this is normal, and enjoy your baby through this period of time, the result will be a good reliable milk supply for however long you wish to breastfeed.
 
4.THE MORE YOU TAKE, THE MORE YOU MAKE: You may have heard this one before and be quite familiar with it, but it’s quite a hard concept to grasp sometimes. It’s a “Supply and Demand” situation and it equates to “The more frequently you feed or pump e.g. empty your breasts, the more milk will be made”.
 
5.THE 40 MINUTE RULE: This is a really good one to remember: a) It only takes 40 minutes for a breastfed baby’s stomach to empty and for the baby to be ready to feed again. It’s called “Gastric Emptying Time” and it is surprisingly short. The breast milk is in fact the most easily digested fluid in the world. It is very low in protein but highly nutritious and perfect for your baby in every way.
                     b) It only takes 40 minutes for your breasts to fill and be ready to feed from again. Inside your breast is like a factory, full of milk producing cells in your breast tissue. A breast is NEVER completely empty and the milk producing cells respond to the breasts being emptied. If the breast is emptied the production speeds up, if left full, it slows down. That’s why, if you feel your milk supply is low, it’s a great idea to feed more frequently and to do some pumping.
 
6.THE CRYING BABY RULE: A crying baby is a hungry baby: Too simple?? Maybe, but true all the same. MOST newborns are crying because they are hungry and the only other reason they cry is because they are being separated from their mothers, or “put down” in the cot. If you don’t believe me, refer to all of the rules above!
 
7.EATING IS PLEASURABLE FOR ALL HUMAN BEINGS: These are my thoughts on “wind”, “colic”, and “reflux”. These words may shock and upset you as you may have thought that your baby is definitely in pain at some stage, or even on most days. Think about when you eat and drink yourselves and how often it is debated that “food is better than sex”!! The human body is born to enjoy eating and drinking and most of us do enjoy it on a regular basis. Our digestion is controlled automatically by the “autonomic nervous system” and after our food has passed pleasurably through our mouths and throats and into our stomachs, we are basically unaware of any other part of the process of digestion. There are several reasons that a parent thinks their baby is in pain. The baby has a very thin layer of skin over its digestive organs and so we can feel and hear and even see the digestion happening. The baby, lying on its back and crying, does so with its whole body, jerking its legs and arms and waving around with no control…..because it has no ability to cry in any other way. It looks like the knees are drawing up in pain and we have perceived this to be pain for a long time now. When a baby needs to burp, it will, and the same goes with the other end…out it comes, no inhibitions there! “This baby is very windy” is the adult response……only because we can hear it is the truth of the matter.  The actual process of a baby feeding at the breast, becoming full, digesting the milk, and then passing it out the other end, is a PAINLESS process. Most babies will cry due to hunger and separation and their very immature nervous system. Your baby needs lots of cuddles, lots of love and lots of help to feed and sleep. No baby, throughout the history of mankind, has been harmed in any way through too much love or breast milk.
 
8. IT’S ALL ABOUT THE FLOW: One of the most important concepts to learn about when breastfeeding is THE LET-DOWN or MILK EJECTION REFLEX. When your baby calls out to you, cries, snuggles in and starts to suckle, a message is sent via your nervous system to a part of your brain which in response to this stimulation, sends out the hormone OXYTOCIN. It’s my favourite hormone because of how amazing it is and the many wonderful things it can do. The main function of Oxytocin with breastfeeding is to allow your milk to come out of your breasts and into the baby’s mouth. The hormone travels through your blood stream to the muscles surrounding your milk ducts and pushes the milk out of your breasts. You may see your other breast start to leak as you are feeding from one breast, you may feel a tingling sensation, or you may just notice that the baby has stopped “flutter sucking” and has started sucking and swallowing, loudly and rhythmically…..this is the “Let-Down”.  At the same time you may start to feel all dreamy and filled with love, sleepy and thirsty….it’s all the work of Oxytocin, “hormone of Love, Lust and Labour”. We even release Oxytocin when we kiss our loved ones, as there are special little receptors on our lips to stimulate its release. The thing to remember with breastfeeding is that you can have five or six “let-downs” per breast per breastfeed. The breast milk flows and ebbs away again and then a new flow comes. Remember always….NO LET-DOWN, NO MILK.  If your baby is fussing around at the start of a breastfeed he or she may be waiting for the let-down and becoming impatient for the flow. This is your indicator to relax, breathe deeply, stroke your baby, try some skin-to-skin and let it all happen. As the baby gets older and starts fussing at the end of a feed this may mean that the flow has ebbed off and the baby, once again, is becoming impatient for more or, in fact, has had enough for now and has other things to do with his time rather than lying around with mum anymore. So, the message is…..whatever happens with your feeding, think about the Let-Down Reflex and remember its ALL ABOUT THE FLOW.
 
 
 
 

Today I want to talk about some of the common myths associated with breastfeeding that can make it difficult for some mums to relax about their feeding and their baby. As a Lactation Consultant and as a midwife I find I am dealing with these myths on a daily basis.

To begin with I would like to touch a little on the recent history of breastfeeding. By looking at what has happened in the last century or more to infant feeding, we can understand more fully how people have become confused about breastfeeding and how so many myths have occurred.

To understand where we are now, we need to go back in time more that 150 years when the Industrial Revolution was in full swing. It was an extremely innovative time in history and there was a sudden improvement in standards of living and every day comfort as a result.  Products that we all now take for granted, like reliable sources of heat and light and indoor plumbing, were widely available for the first time to ordinary people. Science was also making huge advances, especially in the health industry, with the discovery of the germ theory of infection, antibiotics were saving lives, and anaesthesia was invented. Many traditional methods of health and healing were seen as out of step with the new science and the old ways of doing things suddenly seemed out of place in the new technological age……including breastfeeding!!!

For the first time in the history of mankind, scientists and doctors became involved in the formally “secret women’s business” of infant feeding and parenting. The midwives, which literally means “with woman”, were replaced by scientists and doctors advising mothers not to spoil their babies with affection, to provide them with a clean and sterile environment, and to use a strict schedule for everything from eating to sleeping to toilet training.

It wasn’t long before the scientists had developed man-made baby milk. They called it “formula” in reference to its scientific origins and actually came to believe that it was better for babies than their own mother’s milk. It was easy to tell just how much a baby was taking and therefore feeding could be regulated and monitored in a precise way. It all sounded great but in reality in the 1920’s researchers found that babies fed with these nonhuman milks were far sicker than their breastfed counterparts. Luckily for us, huge steps forward have been made in the production of formula for our babies today and it is a safe alternative to breastfeeding now.

While these steps were being made to make formula safe for our babies a lot of research was also being done on breast milk and its various properties and the more you read about it the more you will be amazed at its make-up. As a Midwife and a Lactation Consultant I am obviously passionate about breastfeeding and breast milk but I don’t like to “ram” it down my client’s throats, so to speak, but rather make sure that I am giving all mothers an informed choice and consistent advice.

Consistency is the key here and I have so many mums complain to me that they have had “conflicting advice” given to them regarding breastfeeding in general, especially in the early days. My response is always this:

1.     After you have had a baby you are very tired and overwhelmed.

2.     During your hospital stay you have the potential of meeting and being cared for by up to 12 different midwives.

3.     All the midwives are different people with different caring styles and different approaches to a problem or question that you may have.

4.     Every day in hospital is different from the last and your baby’s behaviour is changing from hour to hour.

5.     All advice and suggestions are good and are given with the best of intentions….some may just work better for you than others. Take it all on board and sort through which suggestions you like and which you do not.

6.     Just getting pregnant seems to give the wider community license to advise new parents with their thoughts on the subject, usually gathered from personal experience.

Here are some of the more common myths that I have gathered in my personal data base over the years:

Myth 1.: Mothers with fair skin and fair or red hair will get sore nipples

Answer: False. The main reason for sore nipples is a poorly attached baby who is “nipple” feeding and not “breast” feeding. A deeper latch is required.

Myth 2.: If a baby is fed too frequently, the nipples will get sore.

Answer: False. No matter how often a baby asks to be fed (and that can be very frequently, especially in the early days), if the baby is properly attached the nipples will not become sore.

Myth 3.: A newborn baby needs to spend a certain amount of time each day asleep in the cot.

Answer: False. A newborn baby does not need to spend any time separated from its parents. Infant humans are born, in fact, only half way through their gestational period. This is so that the human baby’s head can fit through the mother’s pelvis. It takes a good nine months for the brain to grow to its full size and by that time it would definitely not fit through. Babies need lots of love and lots of feeding in the early days and for them to be alone is sometimes a stressful thing for them. By nature, they will call out to you to please come and be with them and that way they know instinctively that everything will be alright.

Myth 4.: Rotating the position of the baby on the breast will help to drain different areas of the breast.

Answer: False. This is a really recent myth but it has been proven that no amount of changing your baby’s position on the breast will help with breast drainage. Just get comfortable. The best way to help drain your breast is to relax so that the let-down occurs, and then you can try some breast massage or compression.

Myth 5: Using a nipple shield will give the baby wind.

Answer: False. When a baby is attached correctly, whether on a shield or not, there is no opportunity for the introduction of air in to the feeding process.

Myth 6: Nipple shields compromise milk supply.

Answer: False. There is no evidence that a nipple shield affects the milk supply. As long as the breast is properly drained, and sometimes the nipple shield can help this to occur, the milk will be replaced. Remember the important concept…..the more you take, the more you make. There can be some negative press about nipple shields but I think that they have a use in the scheme of things and if a shield is needed for breastfeeding to continue, then I support their use. Most mothers will wean from the shield eventually but they may need help with this process from a health professional.

Myth 7: Babies feed four hourly.

Answer: False. Some babies may, in fact, feed every four hours and you may have even been advised to wake your newborn to feed at the four hour point if it is still asleep. The recommended minimum amount of feeds per 24 hours is 6. The reality of a breastfed baby is more like 8 to 12 feeds per 24 hours. The “gastric emptying” time of a breastfed baby is up to twice as fast as a formula fed baby as the breast milk is the most easily digested food available in the world. Forty minutes after a feed of breast milk the baby can have an empty stomach and need another feed. I find that if parents are aware of this fact and relax into it, they find the whole process easier to deal with. The stress levels become very high if the expectation is feeding four hourly and the reality is more like every two or three hours.

To understand the normal physiology behind a newborn baby, and to then relax into parenthood due to that understanding, to me makes a lot of sense. If your newborn cries, pick it up, feed it, love it,  throw away your clock, “tell” your newborn that it is safe in your arms and there is no need to stress.

Happy parenting.

Here is an interesting story for us all to think about in relation to what is happening out there in our modern society.

I was asked to see Annie, a first time mum to 15 week old baby Sophie. I drove to their home and was greeted at the door by 60 year old Granny who stood about 4 foot 6 inches tall and would have been lucky to weigh in at 45kgs. Close behind her was 5 foot tall, at a pinch, Annie, lucky to weigh in at 50kgs. She was holding beautifully fat Sophie, whose thighs will have her off to Weight Watchers if they remain this way into the future.

Sophie was born at term, a normal delivery, weighing 2820gm (the 25th percentile...just like her mum and Granny). She left hospital 4 days later at 2800gm. Yesterday she weighted 5320gm, (the 25th percentile....someone has to be there for the chart to make any sense!!). The baby had put on 160gm per week since birth on average, over 20gm a day when looking at the total weight gain. Her output was normal....lots of wet and dirty nappies....and Annie reported to me that she fed 7 or 8 times a day at 2 to 3 hourly intervals from one side per feed, then had a relatively long feed, taking both breasts in the late evening. She then slept until about midnight, fed, then went back to sleep until 5 or 6am. She is "great" at night but in the day only sleeps for 45 minutes at the most then wakes to feed, plays and then sleeps again for a while.

I watched Sophie feed. She went to the breast, "flutter" sucked for a while, fussed a bit and pulled on and off the breast for a minute. Then.....LET-DOWN!! Suck, swallow, suck, swallow, loud and gulping, for 5 minutes maximum, followed by more pulling on and off and fussing.....I suggested she had finished. Annie sat her up and Sophie then proceeded to join in the conversation for the next hour, smiling and "talking" to us on and off. A beautiful baby!!

SO, I hear you say....what is the problem?

Annie had read some books, names not mentioned here, early on, which had set her off on a path of "control". She felt then that things were not going as the book suggested and went to a special doctor....name again not mentioned, but suffice to say that he "guaranteed your baby to be sleeping through the night by 12 weeks of age...or your money back"!! Sophie was weighed by this doctor who said that the 180gm weight gain over the last two weeks was "dangerously low", the baby was "failing to thrive" and that this was an "emergency" (did he miss those thighs??). Annie was told to feed 10 minutes each side, then top up with a bottle of 60mls of EBM or formula after each feed.