“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).
And:
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??
via 5 Cool Things No One Ever Told You About Nighttime Breastfeeding | Breastfeed Chicago.
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!
Last week, my photographer friend Karen did a photo shoot for my other friend of Goddess Garb and I helped her model her gorgeous robes!
Lovely post, I just LOVE that first photo! Thanks for sharing!
I have to admit I’ve become a huge fan of Dr. Newman since discovering him (I think) through your blog. My son is 32.5 months and we are “still” nursing. For a long time before finding Dr. Newman I thought (in no particular order, usually thought about in the middle of the night when my son was awake and upset or something): 1. he has undiagnosed reflux, 2. I have an oversupply, 3. I have low supply, 4. all this time his latch has been poor, 5. he has an undiagnosed tongue tie/lip tie, 6. he’s sensitive to dairy, 7. he’s allergic to gluten, 8. it’s the food dyes and additives, 9. basically something is “wrong” because he won’t sleep long stretches, he won’t go to sleep (except at daycare LOL) without the boob, etc. Over time though and after reading some of Dr. Newman’s posts I’ve been thinking more and more that the way things went for us was the way it was supposed to go for us. I think breastfeeding, like birthing, is vastly misunderstood, and that all forms of normative breastfeeding dyads are not represented, even in more “liberal” circles, groups, etc. I like that he is radical, says what he thinks, and bucks the trend of doctors know all. His recent post on facebook got a lot of angry comments but he’s right IMHO. Reflux seems to be over-diagnosed. Everywhere I look in my facebook groups related to breastfeeding, so many moms say their child has reflux. Or food allergies. Maybe it’s wishful thinking but I do tend to believe that what we eat does not translate directly into our breastmilk content. And normal behavior at the breast during regressions/growth spurts/teething is seen as reflux and the baby is put on meds. Anyway not trying to hijack your post.