Over the last few days, I have had the pleasure of helping many mothers restart and become confident about breastfeeding. In these consults, as well as on our Healthy Mother Breastfeeding Support Network, two questions keep cropping up: “Can I do it (without supplemental feeding)” and “Will my baby have enough?” The simple answer to both questions is: Yes!!
Two years ago, I attended a lecture on breastfeeding by Nancy Mohrbacher at the Lamaze International Conference. Nancy has also co-authored a book called Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers. These seven laws are simple, yet profound and powerful, and give the control of breastfeeding to the mother-baby pair, rather than care-providers telling or teaching the mother what to do. So, I thought it might be worth re-telling .. here are Nancy Mohrbacher’s Seven Laws of Breastfeeding ..
Law #1: Babies are hardwired to breastfeed
Anyone who has watched a newborn crawl within minutes after birth and self-attach, knows exactly what this means! Here is a link to a beautiful breastcrawl video shot in Maharashtra. Delivery self-attachment was first described by Swedish researcher Lennert Righard in the 1960s; the ability of babies to find the breast and self-attach continue to amaze parents and care-providers alike. Babies know how to do this .. if we let them! It is equally important that for the sequence of breastfeeding events to occur post-birth, we do not separate mother and baby, and allow for unlimited skin-to-skin contact (as seen with other mammals) so that the mother-baby pair can discover each other. As Nils Bergman says, “Mothers don’t breastfeed, babies breastfeed!”
Law #2: Mother’s Body is baby’s natural habitat
While they are skin-to-skin, mothers and babies regulate each others physiological responses. Kangaroo Care and co-sleeping are excellent ways to not only promote better breastfeeding, but also promote better bonding. The benefits of Kangaroo care have been studied in many countries including South Africa, Columbia and India. In a study done in India, babies who were born premature at around 30 weeks, and had average birth weight of 1460 gms, improved their oxygen saturation and regulated their temperature and respirations better, and thus had lower rates of infant mortality, when given Kangaroo Care. Mothers who co-sleep or provide Kangaroo care also report feeling close to their babies, felt more confident about understanding and handling their infants, and felt that it improved their mood as well. So, breast feeding is Interdependent!
Law #3: Better Feel and Flow Happen in the Comfort Zone
When mothers are comfortable, babies get comfortable too. It is not about the mother positioning her baby. It is about baby finding a position of comfort for herself; if baby is calm and kept vertically on mothers’ chest, invariably they will get themselves to a good position which gives them the best angle to open their mouth and breastfeed well.
Law #4: More Breastfeeding at First Means More Later
Feed, feed, feed – especially the more the mother-baby pair are given encouragement to be together and feed on demand, the more milk the mother produces! It is not about “seeing the milk” .. many hospitals have nurses and assistants who pull at mother”s nipples and try to squeeze (painful!!) it in order to “see” if there is breast milk!! All this does is makes the mother sore; babies are the most efficient breast-pumps, and they are able to suckle out far more than what we are able to see. To this end, babies have to be active in the first minutes and hours of life – medications during labor that sedate mother also sedate baby, and hospital procedures that separate mother and baby are not conducive to this “more breastfeeding at first” and thereby hamper the demand-supply.
Law #5: Every breastfeeding couple has its own rhythm
Feeding frequency, feeding length and feeding patterns vary for every baby. Many infants are at the breast constantly during the evening hours! The newborn’s stomach is the size of a small marble, and breast milk is easily digestible .. so, it is natural that they will seek frequent nourishment. The pattern of feeding in mammals is determined by the composition of milk. While Cacche mammals such as deer and rabbits feed every 12 hours due to the super-high protein composition in their breast milk, human milk with the lowest levels of protein requires frequent breastfeeding – at least 10-12 times in a 24 hour period! What interferes with this is scheduling feeds, regular supplements and regular pacifier use. Letting the mother and baby hone in and regulate their feeding patterns and rhythms works best for both!
Law #6: More milk out, is more milk in
A completely drained breast makes milk faster, as compared to a semi-full breast. So, it makes sense to feed the baby on one breast at each feed, rather than give a few minutes at one breast and few minutes at the other. Since the storage capacity of mothers breasts are different, and suckling efforts of babies differ, some babies will need shorter, less frequent feeds, and other babies will need longer, more frequent feeds; and some might even need to go feed on the other side, once the first breast is emptied. Again, each and every mother will have enough for her baby as long as she is breastfeeding her baby on demand and exclusively. The conflicts and questions regarding whether “Do I have enough”, and “my baby is still hungry after he has fed”, and “my baby took 50 ml from the bottle even after she breastfed” are arising because we are applying bottle-feeding norms to breastfed babies! Bottles are the “Lays chips” of breastfeeding .. babies will take a bottle even when they are not hungry, because it gives them the suckling comfort, and the milk flows without them having to work for it! Research has been found that at 6 months, babies on formula take 22% more milk than babies who are breastfed. And, there are studies connecting bottle feeding to tendency to obesity in later life.
Law #7: Children wean naturally
Some mothers are worried that their babies will nurse “forever” if they are allowed. It is just not so; some babies will actively show an interest in solid foods and start weaning themselves off earlier than we expect, and some babies will do so later. Cultural influences also play a role in this. Ayurvedic texts from 1500-800 BC prescribe exclusive breastfeeding for the first year, followed by breast milk and solids for the second year and gradual weaning after that. They knew that breast milk was essential for survival!! The current recommendations by WHO are 6 months of exclusive breastfeeding, followed by breastfeeding upto 2 years.
What does all of this tell us? Yes, mothers will always have enough to breastfeed their infants. What can they do? Spend plenty of time with their baby in those first few days; they will begin to recognize their baby’s feeding cues and also be able to promote soothing behaviours, which will further open the mother-baby pair to emotional interactions. This in turn will produce more Oxytocin, the hormone responsible for feeling warmth, love and relaxation, as well as promote milk let-down to happen easily. All of which will then enable a better breastfeeding experience. It is also important for mothers to realize that though the effort to breastfeed is maximum in the first week or so after the baby’s birth, it continues to need some effort until 6 weeks or so, after which the mother and baby can continue their breastfeeding dance effortlessly!!
So, go on – breastfeed your babies with confidence; After all, breastfeeding happens …. naturally!!