Updated: Nov 9, 2020
We are lucky enough to live in a time where breastfeeding is supported and promoted by our health care system because the benefits have been well documented for decades. The concern has now become, how do we get families off to the right start with breastfeeding? And how can we support them in continued breastfeeding after they go home from their birthplace?
For the past few decades, the general thought was that a baby's first feed after being born was something that needed to be initiated by the birthing person, with the assistance of a birth attendant. Babies were often put right to the breast immediately after birth, whether or not they showed signs of being ready to feed. This has been done with the best intentions, initiating early breastfeeding has been shown to improve outcomes for both the birthing person and the baby. However, we are now beginning to understand how this is a misguided method, as babies are born with innate feeding instincts that allow them to initiate the first feed when they are physiologically ready.
Imagine the following scene: a first-time mother has just given birth after a long and difficult labor. Her baby is placed on her chest, where he comfortably rests and adjusts to the outside world. A few moments later, a birth attendant comes to assist in getting the baby to latch. Baby is still looking sleepy, but is taken and positioned with his mouth at the nipple, he begins to cry at being moved around, the mother's breast is grabbed by the birth attendant, and the nipple is forced into the baby’s mouth. He might start to suck, and quickly become tired again and fall asleep, he might become more disoriented and cry harder. Either way, this is not the recipe for a successful first feed. In fact, this scenario can lead to less confidence in the ability to breastfeed, and a missed opportunity for baby to learn important feeding skills.
What if, instead of being disturbed during his resting period immediately after birth, the baby was left as is? There has been more and more documentation in the past decade that there is a predictable and universal series of behaviors shown by newborns to initiate the first latch without hands-on manipulation by the parents or birth attendants.
Now imagine this scene: the baby has been placed on his mother’s stomach immediately after birth, he quickly stops crying, and quietly looks around, during this time, his circulatory system is beginning to work on its own for the first time, as is his digestion. His eyes are adjusting to the bright lights of the outside world, his skin is becoming dry for the first time. He is kept warm on his mom, and the skin to skin contact helps his body reduce the stress hormones leftover in his system from labor. He might sleep for a short time, or he might begin to show feeding signals right away. Eventually, he begins to move and searches for the mother's nipple. All the while, the mother is able to rest, and take in her new baby. The skin to skin contact releases the hormone, oxytocin, which helps the placenta detach from the uterus and reduces the risk of postpartum hemorrhage. After some time exploring his hands and his mother’s breast with his mouth and tongue, he is able to maneuver himself to the nipple and after a few tries, is able to latch on successfully. Witnessing this, the mother has a new sense of confidence that her body and her baby are capable of breastfeeding......
Continued in pt2