Women's Options in Maternity Care & Birth
Informed choice for every woman's birth!
Feeding Your Baby
Choosing how to feed one's baby can be a difficult choice for many women - and carries with it a lot of controversy these days. Breastfeeding is best, but it isn't always easy. Breastfeeding can be physically and emotionally painful and trying. Breastfeeding was so difficult for me and I wish I had more support. The best thing any new mom can do is get as much information as possible, build a reliable support system and learn from others. I hope the following can be of help to you. Remember - be informed!
Breastfeeding—Starting Out Right
Breastfeeding After a Traumatic Birth
Breastfeeding Support & Information Links
Breastfeeding—Starting Out Right
The following is an excerpt from the handout "Breastfeeding - Starting Out Right" by Dr. Jack Newman. To read the entire handout and for more information click here.
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The trick to breastfeeding is getting the baby to latch on well. A baby who latches on well, gets milk well. A baby who latches on poorly has more difficulty getting milk, especially if the supply is low. A poor latch is similar to giving a baby a bottle with a nipple hole that is too small—the bottle is full of milk, but the baby will not get much. When a baby is latching on poorly, he may also cause the mother nipple pain. And if he does not get milk well, he will usually stay on the breast for long periods, thus aggravating the pain. Unfortunately anyone can say that the baby is latched on well, even if he isn’t. Too many people whoshould know better just don’t know what a good latch is. Here are a few ways breastfeeding can be made easy:
1. A proper latch is crucial to success. This is the key to successful breastfeeding . Unfortunately, too many mothers are being "helped" by people who don’t know what a proper latch is. If you are being told your two day old’s latch is good despite your having very sore nipples, be sceptical, and ask for help from someone else who knows. Before you leave the hospital, you should be shown that your baby is latched on properly, and that he is actually getting milk from the breast and that you know how to know he is getting milk from the breast (open mouth wide—pause—close mouth type of suck). See also the website www.thebirthden.com/Newman.html for videos on how to latch a baby on (as well as other videos). If you and the baby are leaving hospital not knowing this, get experienced help quickly (see handout When Latching). Some staff in the hospital will tell mothers that if the breastfeeding is painful, the latch is not good (usually true), so that the mother should take the baby off and latch him on again. This is not a good idea. The pain usually settles, and the latch should be fixed on the other side or at the next feeding. Taking the baby off the breast and latching him on again and again only multiplies the pain and the damage.
2. The baby should be at the breast immediately after birth. The vast majority of newborns can be at the breast within minutes of birth. Indeed, research has shown that, given the chance, many babies only minutes old will crawl up to the breast from the mother’s abdomen, latch on and start breastfeeding all by themselves. This process may take up to an hour or longer, but the mother and baby should be given this time together to start learning about each other. Babies who "self-attach" run into far fewer breastfeeding problems. This process does not take any effort on the mother’s part, and the excuse that it cannot be done because the mother is tired after labour is nonsense, pure and simple. Incidentally, studies have also shown that skin-to-skin contact between mothers and babies keeps the baby as warm as an incubator (see section on skin to skin contact). Incidentally, many babies do not latch on and breastfeeding during this time. Generally, this is not a problem, and there is no harm in waiting for the baby to start breastfeeding. The skin to skin contact is good for the baby and the mother even if the baby does not latch on.
3. The mother and baby should room in together. There is absolutely no medical reason for healthy mothers and babies to be separated from each other, even for short periods.
- Health facilities that have routine separations of mothers and babies after birth are years behind the times, and the reasons for the separation often have to do with letting parents know who is in control (the hospital) and who is not (the parents). Often, bogus reasons are given for separations. One example is that the baby passed meconium before birth. A baby who passes meconium and is fine a few minutes after birth will be fine and does not need to be in an incubator for several hours’ "observation".
- There is no evidence that mothers who are separated from their babies are better rested. On the contrary, they are more rested and less stressed when they are with their babies. Mothers and babies learn how to sleep in the same rhythm. Thus, when the baby starts waking for a feed, the mother is also starting to wake up naturally. This is not as tiring for the mother as being awakened from deep sleep, as she often is if the baby is elsewhere when he wakes up. If the mother is shown how to feed the baby while both are lying down side by side, the mother is better rested.
- The baby shows long before he starts crying that he is ready to feed. His breathing may change, for example. Or he may start to stretch. The mother, being in light sleep, will awaken, her milk will start to flow and the calm baby will be content to nurse. A baby who has been crying for some time before being tried on the breast may refuse to take the breast even if he is ravenous. Mothers and babies should be encouraged to sleep side by side in hospital. This is a great way for mothers to rest while the baby nurses. Breastfeeding should be relaxing, not tiring.
4. Artificial nipples should not be given to the baby. There seems to be some controversy about whether "nipple confusion" exists. Babies will take whatever gives them a rapid flow of fluid and may refuse others that do not. Thus, in the first few days, when the mother is normally producing only a little milk (as nature intended), and the baby gets a bottle (as nature intended?) from which he gets rapid flow, the baby will tend to prefer the rapid flow method. You don’t have to be a rocket scientist to figure that one out, though many health professionals, who are supposed to be helping you, don’t seem to be able to manage it. Note, it is not the baby who is confused. Nipple confusion includes a range of problems, including the baby not taking the breast as well as he could and thus not getting milk well and/or the mother getting sore nipples. Just because a baby will "take both" does not mean that the bottle is not having a negative effect. Since there are now alternatives available if the baby needs to be supplemented (see handout #5, Using a Lactation Aid, and handout #8 Finger Feeding) why use an artificial nipple?
5. No restriction on length or frequency of breastfeedings. A baby who drinks well will not be on the breast for hours at a time. Thus, if he is, it is usually because he is not latching on well and not getting the milk that is available. Get help to fix the baby’s latch, and use compression to get the baby more milk (handout #15, Breast Compression). Compression works very well in the first few days to get the colostrum flowing well. This, not a pacifier, not a bottle, not taking the baby to the nursery, will help.
6. Supplements of water, sugar water, or formula are rarely needed. Most supplements could be avoided by getting the baby to take the breast properly and thus get the milk that is available. If you are being told you need to supplement without someone having observed you breastfeeding, ask for someone to help who knows what they are doing. There are rare indications for supplementation, but often supplements are suggested for the convenience of the hospital staff. If supplements are required, they should be given by lactation aid at the breast (see handout #5), not cup, finger feeding, syringe or bottle. The best supplement is your own colostrum. It can be mixed with 5% sugar water if you are not able to express much at first. Formula is hardly ever necessary in the first few days.
7. Free formula samples and formula company literature are not gifts. There is only one purpose for these "gifts" and that is to get you to use formula. It is very effective, and it is unethical marketing. If you get any from any health professional, you should be wondering about his/her knowledge of breastfeeding and his/her commitment to breastfeeding. "But I need formula because the baby is not getting enough!" Maybe, but, more likely, you weren’t given good help and the baby is simply not getting the milk that is available. Even if you need formula, nobody should be suggesting a particular brand and giving you free samples. Get good help. Formula samples are not help.
Under some circumstances, it may be impossible to start breastfeeding early. However, most “medical reasons” (maternal medication, for example) are not true reasons for stopping or delaying breastfeeding, and you are getting misinformation. Get good help. Premature babies can start breastfeeding much, much earlier than they do in many health facilities. In fact, studies are now quite definite that it is less stressful for a premature baby to breastfeed than to bottle feed. Unfortunately, too many health professionals dealing with premature babies do not seem to be aware of this.
Handout #1. Breastfeeding—Starting Out Right. Revised January 2005
Written by Jack Newman, MD, FRCPC. © 2005
This handout may be copied and distributed without further permission, on the condition that it is not used in any context in which the WHO code on the marketing of breastmilk substitutes is violated.
Breastfeeding Stories
Nicole's Story
Of course, now we had another problem. He didn’t want to latch onto my breast, preferring the stream of milk into his mouth from the syringe while sucking on my finger. Pumping and freezing my milk was thankfully effortless, so soon we had a freezer full of milk. Patiently, I offered him my breast day and night, and slowly, he began to nurse again, as he was meant to. When he was 3 months old, he finally was 100% breastfed and did not need the syringe anymore. And after struggling for 3 months, I had no plans to give up breastfeeding anytime soon!
I knew I had to return to work when he was 7 months old. I pumped milk like a wild woman, filling up Ziploc bags bursting at the seams with little pouches of breastmilk. I was so lucky to have my mother take care of him when I returned to work, and she drove him to me on my lunchbreak so I could nurse him. For the rest of the day with her, he would have bottles of my milk, and extra nursings at night and on the weekends. I had pumped enough milk to last him until he turned 12 months old, and by then, he was big enough to drink out of a cup.
I successfully breastfed my son until he was 16 months old, when I sadly weaned him. I am proud that I followed my heart and persisted during difficult challenges and kept my baby close to my breast. Today, I am breastfeeding my second son, who is two, pregnant with my third son, and very much looking forward to my next adventure---tandem nursing!
Tandem Nursing
Generally defined as "nursing two different-aged children" or nursing more than one child. We are currently researching an article on this topic. The following are some helpful links:
Nursing During Pregnancy and Tandem Nursing: The Official FAQ
LLL International - Tandem Nursing
Recommended Reading
Adventures in Tandem Nursing: Breastfeeding During Pregnancy and Beyond - (2003) by Hilary Flower
Breastfeeding After a Traumatic Birth
Because of my own experience with my daughter, who refused to nurse following a forceps/vacuum assisted delivery, I am currently researching breastfeeding difficulties following a traumatic birth. Below is some of the information I have found so far:
Helping a Mother with a Baby Who Is Reluctant to Nurse ( LLLI)
The Impact of Traumatic Birth on Health Through the Loss of Breastfeeding (excerpt from an article by Cynthia Good Mojab)
When the Baby Refuses to Latch on (Dr. Jack Newman)
When a Baby Won't Nurse (LLLI)
Breastfeeding Support & Information Links
Breastfeeding Online - Featuring Dr. Jack Newman's articles
Monthly meetings the 2nd Thursday of every month at 10:00 AM at the Volunteer Centre, 856 Allowance Ave S.E., Medicine Hat, Alberta T1A 7S6. Phone or email a La Leche League leader for more information.
- Colleen 306-662-4979 colleen.kennedy@sasktel.net
- Irene 403-526-4840
- Tina 250-724-7325
Canadian Breastfeeding Foundation
Community Health Services Breastfeeding Drop-In Clinic - Every Wednesday afternoon 1:00 - 3:30 PM
Medicine Hat - Terry Lawson, LC (403) 502-8200
Brooks - (403) 501-3300
Breast Friends 4 Moms - Peer support for breastfeeding mothers
Call Janice (403) 528-5609
International Lactation Consultants Association (ICLA)
Mothers Overcoming Breastfeeding Issues (MOBI)
PLEASE NOTE: All information expressed on the WOMB website and in our workshops, sessions, and/or consultations is to be used for informational purposes only. We are not providing medical advice as we are not licensed medical professionals. Therefore, we cannot be held liable for unforseen outcomes.