This post is written because I have been asked so many, many, MANY times “how do you breastfeed?” Breastfeeding is something I am passionate about. I liken it in my mind to reading or travel… experiences which can be confronting, hard to master and present ongoing challenges, but which intrinsically enrich your wellbeing. And that’s not to even mention the many well-researched and documented health benefits for mothers and their babies. But I won’t bang on about those because if you’re actually pregnant and considering breastfeeding, you’re likely to have them endlessly shoved in your face already. What you are less likely to hear about is 1. how the heck you actually do it, 2. how you keep doing it once you’ve got the hang of it and 3. what it’s really like…
I also feel it is my responsibility to add my voice to the conversation on how to better support the choice to breastfeed. Frankly, I don’t believe that breastfeeding is an easy or even realistic choice for many women. In her article, The Real Breastfeeding Scandal, Carolyn S Miles outlines a report from Save The Children and identifies the major barriers to breastfeeding: community and cultural pressure, health worker shortage, lack of maternity legislation, and inappropriate marketing of breast milk substitutes.
A quick thought on each of those before I get to the how-to bit…
Community and cultural pressure
We claim – as a society – that children are incredibly important to us. Yet we constantly legislate for and normalise things which are in stark contradiction to this claim. eg I’m delighted that mothers who wish to return to work will be getting some new tax breaks, it’s excellent news for them and their families. But David Cameron says it’s about choices for women… what about those who would choose to stay at home but can’t afford to? Research shows that long periods of time in a formal nursery before the age of three increases a child’s levels of insecurity and aggression with long term effect… so why aren’t we encouraging women who want to stay at home with their children to do so? And equally, why are nursery staff some of the lowest paid workers in society? That doesn’t equate to their jobs being some of the most important, does it? And here’s another gripe under the community and cultural pressure heading: Why on earth are women encouraged to wear those naff little bibs to breastfeed in public – it’s like a flowery burkha for goodness sake!! If you want to feed discreetly, that’s great, so do I, but breastfeeding is a normal, happy and healthy activity which doesn’t need to be hidden from public view.
Put simply, we need experts to be available to teach women how to breastfeed. We need them in maternity hospitals, we need them in the community and we need them in our homes. Funding and support for breastfeeding is needed to back up the platitudes we hear about how important it is. Stress, pressure to perform and a heavy dose of guilt is less useful but often seems in greater abundance.
Lack of maternity legislation
This is such a contentious issue and one I am almost (almost!) too scared to mention. However, as a society we need to start a proper conversation about the rights of reproductive women. We need well paid parental leave and access to genuinely family-friendly working arrangements. Will it be expensive? Yes, hugely. But without it, claims that sexual equality exists in the workplace is as laughable as the suggestion that models in mascara ads aren’t wearing false eyelashes. We also need fair, enforceable child support for single parents.
Legislation is important because the most commonly expressed reason women return to work is due to financial needs. If we really believe the research into the benefits of breastfeeding, in particular the huge and wide ranging benefits for women and children (which of course have a long term impact on education, health and welfare) we need to ensure that women have a real choice about whether they can continue to breastfeed which is protected by law and financially supported by the State.
Inappropriate marketing of breastmilk substitutes
It’s one of the international food industry’s nastiest and most poorly-kept secrets. In developing countries it involves promoting formula to women who have little money and limited access to sterilised feeding equipment or clean drinking water. It’s an absolutely disgusting disgrace. Executives and shareholders who have profited from this practice claim it no longer happens. The Guardian wrote a fascinating investigative piece called Milking it in 2007, concluding that the practice was still rife. Whether it is or not, I bear a permanent grudge over it and have boycotted Nestle for this reason since I was about seven (which has become increasingly difficult as they have gradually taken over so many of the food brands I love including Kit Kat!!) In the western world, we think we are too empowered and educated to fall victim to inappropriate marketing… but who is it that spreads those insidious little mistruths about formula v breastfeeding? Who says women can’t produce enough milk to satisfy a growing baby? The survival of our species for the many hundreds of thousands of years prior to the invention of formula shows we can! Who says many women can’t breastfeed? Bollocks! Evolution proves that most can! And who started the rumour that babies sleep better with a tummy full of formula? Some evil genius who counted on women being exhausted, emotional and desperate for a few hours of uninterrupted shut eye..? and stood to make colossal amounts of money from the assertion..?
Now that I’ve got all that off my chest let’s move on to the how-to bit. I believe that a lot of people downplay the hardships and difficulties of breastfeeding in order to encourage women to give it a go. The problem with this is that if we’re told it’s so easy and fun we’re not expecting the challenges that are so commonly encountered in the early days… and then we feel like we’re failing… and then we choose to give up. I prefer to tell people that breastfeeding can be confronting, difficult, painful and time consuming but it is nonetheless worth persisting with. It is uplifting, life affirming, natural and brilliant too!
How to get started:
1. Start immediately. Just like all mammals, human babies come with an inbuilt sucking reflex. Literally minutes after your baby is born, when she has been placed on your chest and you have just met, you can put her little mouth near your nipple and give it a go. You can encourage a baby to open her mouth by gently stroking around the chin and mouth area. You can use your fingertips or nipple. I have trawled through all sorts of breastfeeding videos and think this one is particularly simple and clear… have a look.
2. Get help. The thing you are most likely to need help with is “latching on”. A good latch includes two things: Firstly, teaching your baby to open his/ her mouth very wide and secondly, getting as much of the nipple and surrounding areola into the baby’s mouth. It can take a bit of time and practice, but it’s worth persisting with as once you get the hang of it it is really, really easy. There are lots of people who can give you good help and advice on breastfeeding. Don’t be frightened to ask! Don’t be frightened to keep asking! Talk to your midwife or health visitor in hospital. Talk to them after you come home. Go and see your GP. Ask about breast feeding drop-in centres and clinics – many have baby weighing and cups of tea to go with some experienced advice. Now is not the time to be shy with either your needs or your breasts.
There are breastfeeding support networks in most countries. These are some good places to start if you live in the UK:
3. Expect some pain. I am surprised when friends (or people on YouTube) say that breastfeeding shouldn’t hurt. I would say that a better description for the pain you feel in the first few minutes for the first few weeks is toe-curling. I imagine it is to do with the nipple getting “tougher”. Most women I have spoken to about this report similar. Further, breastfeeding stimulates the contraction of the uterus, and more strongly so in second and subsequent children. It should feel like a mini-contraction and although it is painful it is a good sign that mother nature is doing her bit to get your uterus back to it’s pre-baby size. So, in terms of pain, when baby latches on for a feed for the first few weeks you can expect pain in the nipple area and pain in the uterus. It should only last for the first couple of minutes, and it should be gone by the time baby is 4-6 weeks old.
4. Make time. Feeding a new baby is a full time job. Your baby may want to feed for as long as an hour every couple of hours. It’s a great time to indulge in your broodiness! Look at your baby, touch her, smell her, uncurl her tiny fingers as she relaxes into the feed, rub her little feet, smooth her hair… I keep a book next to my feeding chair and when I’ve had enough of fussing over Ted I get stuck into some reading. As much as possible, I avoid watching TV or working at my computer while feeding as I like to carve out that time as special, quiet and soothing.
5. Wear nursing pads. Your breasts will leak for a while at least and possibly the whole time you are feeding. The cheap ones are usually less absorbent, and stick out through your top. The more expensive ones are shaped to the breast, thinner, and more absorbent, thus keeping your skin dry and avoiding irritations and fungal infections. I like the Lansinoh ones best.
1. Stick to your guns. Be prepared to encounter the aforementioned community and cultural pressures. You might be surprised how often people suggest you switch to formula feeding or mixed feeding.
2. Get more help. Your health visitor and GP can provide help or access to services in the community which are there to help you. These might be as simple as advice on how to protect your nipples or improve baby’s latch, or just giving you some moral support. In the UK, staying in touch with your NCT group is a good way to have a mini-support network, somewhere to discuss your concerns and triumphs with other women who are going through the same thing at the same time!
3. Expect more pain. Once you’re through the first few weeks, the toe-curl at the moment of latch will dissipate. However, be on the look out for blocked milk ducts or mastitis. These will make themselves known to you via a high temperature and sore points within the breast. Go to your GP.
4. Watch what you eat. I suggest no less than 2000 calories made up of high-protein, healthy-fat, and complex carbs. Make an effort to include things like olive oil, avocados, densely grainy bread, porridge, wholemeal pasta, rice, seeds and nuts, potatoes, pulses, bananas, free range eggs and full cream dairy/soy products. I am vegetarian, so add tofu and Quorn to that list as well, but you might like to include lean meat and fish. The widest variety of fresh, organic, unprocessed food will always be the best option. A food diary is a great way to monitor your baby’s reactions to your diet. The NHS recommend a Vitamin D supplement, decaffeinated tea/coffee and minimal alcohol. They also say that eating peanuts (or not) has no effect on whether your baby will develop a nut allergy. Anecdotally, I eat lots of nuts and none of my children have any allergies/ asthma etc …Oh, and don’t try to lose weight!
5. Drink heaps of water. Where do you think all the fluid in your milk comes from??? I drink at least 3 litres of water a day.
6. Get some rest. Rest while feeding – get comfortable and put your feet up. If you have more than one child to look after, make time for some quiet floor-play every day. Baby can go in their bouncy chair, or in a safe place on the floor while you do puzzles, read stories, build towers with Lego etc with an older child. If you can grab a nap while your baby naps, do it! If someone offers you support or respite take it willingly (and pass on the gesture to someone else at a later date.)
7. Spend a day in bed. If you feel your milk supply is seriously dwindling, try to organise a whole day in bed. Allow your baby to feed for as long and as often as he/she wants – the more baby feeds, the more milk you produce. Rest, read, relax. A supportive friend/ partner can bring you food and drinks, and care for any other children for a 24 hour period.
8. Be kind to yourself and others: If you don’t manage to breastfeed exclusively for six months, be proud of what you have achieved rather than focussing on what you haven’t. Motherhood isn’t a competition, there is room for all of us on the winners podium, so don’t use breastfeeding as a weapon to undermine yourself or others.
What it’s really like…
Well, I’ve spent over a decade of my life either pregnant or breastfeeding! I have found it challenging at times. I have wavered in my commitment to breastfeed and found it surprisingly difficult to get both information and moral support… I have had mastitis, cracked and bleeding nipples and blocked milk ducts… I have had to say no to margaritas!… I have answered my front door without realising my top was still hitched up and my boob fully exposed! I have been puked on, and burped at. I have gritted my teeth and counted to ten during some very sharp early-days pain, and right at the time it was happening it seemed like the most excruciating sting in the world. But breastfeeding has also enabled me to nourish my children with my own body and it has proven a great help in returning my body to it’s non-pregnant shape. I believe breast feeding may have contributed to the robust health all my children have enjoyed since birth including being asthma-, eczema- and allergy-free. I have used breastfeeding to create a quiet, intimate cocoon in which to spend some private quality time with each of my children. I have looked down at each of my children with wonder as they have fed, smiled, laughed and sung during breastfeeding.
Feeding Ted will be the last time I breastfeed and I can honestly say that I will really miss it when he finishes.