“Rules and breastfeeding do not go together well.” –Dr. Jack Newman (LLL of Missouri conference)
Today was our monthly La Leche League meeting and so it feels appropriate to share some of the breastfeeding tidbits I’ve collected recently (or in the past!). I heard Dr. Jack Newman speak at the LLL of Missouri conference and once again enjoyed his refreshingly straightforward and honest style (i.e. “don’t listen to what the health department says, go ahead and let your baby sleep with you!”). I previously heard him speak about Controversies in Breastfeeding at the CAPPA conference in Kansas City:
Colostrum and formula are the same in the following ways: both are liquid.
Breastmilk does not need to supply vitamin D (makes no sense to describe breastmilk as “deficient in” or “lacking” vitamin D).
With regard to the high incidence of reflux being diagnosed in babies—his response to why so high is, “because [most] doctors don’t know anything about breastfeeding.”
We learn one thing when we hear that the mother has been told to feed her baby X number of minutes per side—>the person telling her this does not understand breastfeeding.
There are no such thing as “flat nipples”–women have normal nipples. We live in a bottle feeding culture that makes us assume that if a mother does not have nipples that stick out like a bottle nipple, the nipples are flat (**Molly’s own note–we also live in a culture where 75-90% of women have epidurals during labor which can contribute to edema in the breast and the accompanying appearance of flat nipples).
Dr. Newman also emphasized the important point that the burden of proof rests upon those who promote an intervention! He was speaking with regard to recommending formula supplementation, but I strongly believe it applies to any birth practice. So simple and yet so profound. One example that he shared that is familiar to birth advocates is that lying down for electronic fetal monitoring is a position of comfort for the care provider, NOT for the mother.
And, he made this excellent point: “All medical interventions, even when necessary, decrease the mother’s sense of control, and increase her sense of her ‘body not being up to the task.” Again, the burden of proof rests on those who promote the intervention, not vice versa.
At the recent conference, during his presentation about when babies refuse to latch, Dr. Newman said this:
“Even if a baby doesn’t take to the breast right away, even by 2-3 weeks, almost ALL babies will latch by 4-8 weeks if the mother has an abundant milk production.”
He also reminded us that one cause of latch difficulties is because of the expectation that babies latch on immediately after birth. Many of us are familiar with this and expect all babies to nurse within 20-30 minutes of being born. Dr. Newman says that for some babies, it is normal not to nurse right away and that trying to make them nurse before they are ready is actually a way of creating a real problem with latch. He says that most babies will latch on within 24 hours and that it isn’t necessary to worry about that.
However, speaking of the impact of birth practices on breastfeeding and the potential for babies not to latch immediately after birth:
How could that be, I wondered? If so many mothers have their milk come in after 72 hours, doesn’t it make that pretty normal? Doesn’t this undermine the definition of late onset of mature milk (post 72 hours)?
But then I remembered that many obstetrical practices are associated with late onset of mature milk…
Exactly! This conclusion is supported by data from the recently released Listening to Mothers III Survey, with the following factors known to cause a delay in milk coming in:
Cesarean birth. The CDC reports that 33% of births in 2010 were by cesarean.
Labor induction and augmentation. The Listening to Mothers III Survey found that 41% of mothers said that their providers tried to induce their labor, (63% of those inductions involved pitocin), and 31% had their labor augmented with pitocin.
IV fluids. The Listening to Mothers III Survey found that 61% of women had received fluids by IV (55% of women who birthed vaginally and 77% of women who birthed by cesarean).
Labor pain medication. 83% of mothers in the Listening to Mothers Survey reported having had labor pain medication.
I’ve also recently complained about my toddler’s relentless night-nursing ways and so I enjoyed this article about the benefits of night-nursing:
…Did anyone ever tell you that… in lactating women, prolactin production (prolactin is the milk-making hormone) follows a circadian rhythm? Studies have shown that breastfeeding women’s prolactin levels are significantly higher at night, particularly in the wee hours of the morning. Babies often want to nurse at night because quite simply, there’s more milk at night! (Source) Aren’t our babies smart??
And, the notion of specific “maternal fat stores” has reassured many a mother in my LLL group:
…First of all, don’t worry – losing your butt does not mean you are losing your ability to breastfeed. In fact, it means that breastfeeding is working as intended!
The fat around your hips and thighs is called your gluteofemoral fat. This is a very special kind of fat, as it is largely made up of Omega 3 fatty acids.
Omega 3 Fatty Acids breaks down into;
DHA, EPA and ALA…
Returned to birth-related stuff, the summer edition of the Friends of Missouri Midwives newsletter is finally ready! Check it out and enjoy. The theme for this issue was Movement. The issue also includes a funny, gritty, and inspiring birth story from Halley, who blogs at Peace, Love, and Spit Up.
“It’s not just the making of babies, but the making of mothers that midwives see as the miracle of birth.”
-Barbara Katz Rothman
In other news, my husband had his 36th birthday and I made him a fabulous German chocolate birthday cake with homemade icing (half with fresh coconut and half without coconut, so we were both happy). The recipe uses three sticks of butter and seven eggs!