…so many things to so many people. I hesitate to start the list with any single thing because the meanings people attach to breastfeeding are so different from person to person. Some descriptors(in no particular order) are: natural, healthy, best, beautiful, difficult, gross, impossible, free, painful, time consuming, time saving, easiest, stressful, complicated, right, messy, political, selfless, relaxing, healing, bonding and rewarding.
Any and all of these can be true. Conflicting feelings can simultaneously exist in the same breastfeeding dyad/family and the experience can shift between positive and challenging from day to day, week to week, child to child.
One of the most common descriptions I encounter is, “breastfeeding is natural”, which connotes ease and an overall sense of wholesomeness and well being. Surely, those who navigate the uncertainties of the early stages of breastfeeding are likely to reach to a place of contentment, simplicity, relaxed feelings about breastfeeding and the holistic health benefits that it promises. But the breastfeeding experience is a journey, not a destination, and with all journeys there are going to be high and low points as well as a lot of long, tiresome stretches along the way.
In thinking that breastfeeding is natural and therefore easy, a problem arises when someone planning to breastfeed for the first time expects it to be a relatively passive activity like being pregnant or going in to labor. Indeed, our bodies will undertake the processes of pregnancy, labor and lactation without special thought on our part, but we must engage with those bodily functions in ways that support and optimize them. Just as we choose to avoid harmful substances, eat nourishing foods and study in preparation for a healthy baby and birth, we must also prepare for breastfeeding prior to birth.
Here is an overview of my best recommendations to prepare for success in meeting your breastfeeding goals.
- Engage with other breastfeeding parents: hear their stories, listen to their real-life experiences with breast changes, infant feeding behaviors, maternal-infant biology, family dynamics, newborn care strategies, sleep changes, emotional responses, and expectations.
- Witness breastfeeding in real life. There is real harm in the over-sexualization of women’s breasts and the movement to cover up, shame and demean the act of breastfeeding in public. Breastfeeding is a learned skill, not a passive function. The less that we witness breastfeeding happening in day to day, normal scenarios (without a blanket thrown over it), the more likely that people will not understand what to expect or how to do it, and the risk of developing hang-ups about breastfeeding is magnified. Mental and emotional “hang-ups”about breasts, sexuality and body image are instilled by society and personal trauma, they are not innate; but such hang-ups are a strong marker of potential breastfeeding problems. Some people who wish to breastfeed will have to work hard to overcome societal and personal trauma, in which case it is necessary to begin the healing voyage long before the baby is born, through appropriate therapy and exposure to a world of others for whom breastfeeding is the norm.
- Build a network of helpers you can count on. Here is another word that can mean myriad things to so many people, “network“. We are heavily enmeshed in electronic social circles, with weakening connections to reliable relationships. Solid relationships are those that you can trust to be consistent, dependable, competent, communicative, responsible, fair and believable. When it comes to breastfeeding support, not all sources are reliable. Some internet breastfeeding forums for example, can give a false sense of reliability because they are always on and someone always replies, even when its three a.m. and you’re feeling alone with your struggle to soothe your insatiable three-day-old with cracked, bleeding, engorged and angry nipples. But not all forums are created equally, and some will stray into irrelevant topics, emotionally charged arguments and/or misinformation, all of which can cause more stress than assistance. Stick with well moderated forums that are led by established breastfeeding support organizations such as La Leche League, International Breastfeeding Centre, and/or KellyMom. Additionally, reach out to your family and local community for household, meal, childcare and social support. Plan ahead to have these systems in place. If a supportive family member or friend offers to help, take them up on it by inviting them to do a few loads of laundry, wash dishes, care for older children and bring over a prepared meal. Perhaps a church auxiliary group will organize a meal train for the first few weeks after birth or your neighborhood association will arrange to have volunteers take care of your yard while you recover and rebuild your strength. If you can afford to, hire a postpartum doula, housekeeper or nanny to provide consistent family support during the transitional stages of pregnancy, birth, breastfeeding and early infancy.
- Take a breastfeeding class. Hive CE and Bridgetown Baby have partnered to offer a free, online course for parents and anyone else who is supporting a breastfeeding family. Newborn Feeding: Positions and Other Solutions for Common Challenges is a great place to start your breastfeeding education curriculum!
- BUY and READ the great breastfeeding books.
- The Womanly Art of Breastfeeding , a La Leche League classic, is the go-to manual to have on your nightstand.
- Bestfeeding: How to Breastfeed Your Baby by Suzanne Arms,
Mary Renfrew, Chloe Fisher offers academic knowledge, clinical expertise, and practical skills to educate first-time and experienced mothers alike.
- The Breastfeeding Mother’s Guide to Making More Milk by Diana West, Lisa Marasco is comprehensive book about improving low milk supply .
- Sweet Sleep: Nighttime and Naptime Strategies for the Breastfeeding Family by Diane Wiessinger is a how-to guide for making sane and safe decisions on how and where your family sleeps.
- Strive for a drug-free birth. Good starts to breastfeeding are more likely when the baby is not exposed unnecessarily to drugs during pregnancy and labor. Explore all the options available to help you cope with the pain and discomfort of labor without resorting to medications. Is a shower or bathtub / pool available to labor in? Will you be encouraged to walk around and assume any position you wish during labor? Does your birth team allow intermittent fetal heart monitoring instead of continuous? Will you hire a labor doula? There are many ways to comfort a person in labor that are non-narcotic. Take a comprehensive childbirth education class and practice your techniques ahead of time to assure that the baby is given the opportunity to be born with the fewest impediments to successfully latching and imprinting on the breastfeeding imperative right from the start.
- Wait until after the baby has latched and breastfed at least once before anyone does routine procedures to the baby. By “routine”, I mean weight, measurements, eye ointment, bathing, vitamin k shot, footprints, . In the event that the baby needs help breathing and maintaining their heart, lungs and circulation, breastfeeding can and should wait until the baby is stable.
- Plan to not circumcise baby boys. Long term breastfeeding success may or may not be affected by the act of circumcision depending on which studies you read. However, side effects during the first 24-48 hours after surgery are in direct conflict with optimal conditions for breastfeeding success which are, “a mother and her new baby being together and getting to know each other”(The Womanly Art of Breastfeeding, 3rd ed. Franklin Park, IL: La Leche League International, 1981: 92-93).
- Sleep when the baby sleeps…day or night, for at least the first few weeks.
- Hang in there. Even when breastfeeding is going very smoothly, it takes a whole month to adapt and feel confident in it. The neonatal period (birth to 28 days) is a time of rapid changes in yourself and the baby. During the first week, you will go through a rapid series of changes to your breast shape, size and density. Each change will affect the baby’s ability to latch, suckle, swallow and coordinate their mouth and jaw movements. They will learn to nurse on relatively soft, flat nipples, and by the time they are three days old, the nipples and breasts may be hard, rounded and enlarged. Then after another day or two, the breast changes again and may be softer, but with a more erect nipple than before. They also go from having just a few drops of colostrum to having milk spraying out of the breast in a solid stream. By the time you and the baby get used to the three stages of breast changes in the first week, the baby will go through a growth spurt that can cause them to nurse far more frequently than they did in the first week. As your body adjusts to the new demand for more milk and the baby is again satisfied by the increase, they will settle down during the second week and things can feel like they are going smoothly until week three when another growth spurt is likely and the feeling of baby needing to nurse all the time can be overwhelming. I assure you that by the one-month mark, the timing of growth spurts and cycles of bodily changes will begin to space out and be less of a roller coaster.
In close, I will circle back to my opening thought, breastfeeding is so many things to so many people. It is natural, and it is hard, and it is healthy for mothers, babies, families and society. Breastfeeding is complex and simple at the same time; it is simple in its design and functionality, yet it is complex socially when viewed through the lenses of career, sexuality, religion, family dynamics and gender roles. I hope that the ideas in this post will foster a sense of confidence for your breastfeeding journey, while also giving practical ideas to help you avoid some of the struggles that can happen when getting started.