Breastfeeding – there’s more to it than you might think.

Posted on January 15th, 2020 to Lactation

There’s more to breastfeeding than you might think…

Much has been written and published about the benefits of breastfeeding. It is common knowledge that breastfeeding, or at least breast milk, is best for your baby, but there is more to breastfeeding than you might think. The act of breastfeeding is also good for mother-baby bonding and the transmission of a good microbiome – or seeding of the baby’s gut with the good bacteria from the mother.  Scroll down for tips on how to get off to a good start!

Breast milk IS the perfect food for your baby. It is a complex, living nutritional fluid that supports the baby’s growth by providing the ideal amounts of fat, protein, sugar, and liquids. It also has growth hormones AND antibodies which protect the baby from illness by supporting the baby’s immune system. Breast milk supports a healthy gastrointestinal system by promoting healthy gut flora and suppressing bacterial growth. We now know that healthy gut bacteria (also known as the microbiome) plays an essential role in a person’s health. Having enough milk supply is also a time sensitive process. Getting off to a good start will maximize your body’s ability to make enough milk.  Scroll down for tips on getting off to a good start.

Breastfeeding has been shown in studies to increase a baby’s intelligence; decrease the incidence of asthma (or the severity of it), eczema, and ear infections; reduce the risk of gastrointestinal illness and upper respiratory illness; reduce childhood obesity and leukemia; reduce the likelihood of developing type 2 diabetes; and reduce the incidence of SIDS.

Breastfeeding and lactation are also important to a mother’s health. Hormonally and physiologically, a woman is programmed to have a period of lactation after a birth. This reduces a mother’s risk of ovarian and breast cancer, positively affects her cardiovascular health, decreases the risk of osteoporosis and postpartum depression, and reduces the incidence of type 2 diabetes. If she already has diabetes, breastfeeding helps her control her blood sugars more easily.

A hormonal balance with positive effects for both mother and baby occurs when mother and baby are together, skin-to-skin, during breastfeeding. The release of the hormones oxytocin and prolactin when the mother has the baby close, suckling at the breast, decreases her blood pressure, has a calming, analgesic effect, decreases the stress hormone cortisol (which in turn decreases anxiety and aggressive behavior), and permeates the areas of the brain associated with mothering and bonding behaviors. This hormonal response facilitates more milk production and supports a healthy mother-infant relationship. It also promotes an instinctual response in the baby to orient to the breast and latch on effectively. Having the baby’s body in full contact with the mother promotes breastfeeding. The hormonal response of the mother also facilitates the protective instincts and helps the mother be vigilant and focused on the baby.

So what are we to do if breastfeeding doesn’t get off easily to a good start or the mother and/or baby struggle to breastfeed?

A few simple tips can enhance any breastfeeding experience and also prove helpful in times of difficulty.

Prenatal Hand Expression of colostrum may be a way to provide a good foundation for you and your baby. Especially if you fall into a higher risk group for BF difficulties:

  • Women with diabetes in pregnancy (pre-existing or gestational)
  • Infants diagnosed during the antenatal period with cleft lip and/or palate and congenital conditions
  • Mothers having an elective caesarean section
  • Infants with intrauterine growth restriction
  • Women with breast hypoplasia [a condition where the breasts are not fully developed]
  • Women with hyperandrogenesis (polycystic ovarian disease)
  • Women who have had breast surgery
  • Women with multiple sclerosis
  • Strong family history of dairy intolerance or inflammatory bowel disease.
  • Mothers with high blood pressure
  • Mothers taking beta blockers (e.g. labetalol)

Skin-to-skin. Unwrap/undress baby down to a diaper and mother without a bra or shirt. Having the baby sleep skin-to-skin and be with the mother skin-to-skin as much as possible in the early days helps the baby to reset his or her instinctual responses, promotes frequent feeding, and attunes the mother to early feeding cues which will happen more often when the baby is skin-to-skin. It also promotes the secretion of oxytocin and prolactin, two crucial hormones that drive milk production and promote bonding.

    Frequent feedings. Early and often! Have the baby latch and suck as many as 8-12 times a day to promote the frequent and frequent milk/colostrum removal from the breast. If the baby is unable to latch and suck for any reason, mother should be taught hand expression and remove the colostrum into a teaspoon and feed it to the baby. Double electric breast pumping may be initiated as well, but colostrum is thick and present in small amounts so pumping is often less effective at removing it.

Milk is made by removing it from the breast. The milk supply is driven by supply and demand – so when the milk is removed, more is made. If it isn’t removed, it turns off the system. This process starts within the first hour after birth. The number one reason women stop breastfeeding is due to poor milk supply. If milk is removed early and often, preferably by the baby, it’s is huge step toward generating a good milk supply for the duration of the lactation time period.

Support biological nurturing or natural breastfeeding. Biological nurturing (BN) is a neurobehavioral approach to breastfeeding initiation that aims to reduce latching problems and early unintended breastfeeding cessation. In biological nurturing, mothers lean back and place the baby on top so that every part of the baby’s body is facing, touching and closely applied to one of the mother’s curves or to part of the surrounding environment. Nursing in a laid-back position opens the mother’s body, which promotes neonatal locomotion by releasing up to 20 primitive neonatal reflexes which act as breastfeeding stimulants (Colson et al. 2008).

The first hour:

If you baby can’t remove the milk, hand expression is often the next best thing:

Seek support and assistance from a Lactation Consultant, your midwife, your pediatrician or La Leche League ( local group) if any difficulties arise.

by Marti Churchill, CNM, IBCLC

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