Nikki Lee Health

How we got into the habit of encouraging mothers to throw their milk away.

Breastfeeding entered the mainstream in the 1970s, 80s, and 90s, after being lost to public awareness for a long, long time.  Some brilliant women of the 1940s and 50s were among the rare ones to breastfeed. They paid attention to what they saw, and talked about and wrote about it. Those communications, meetings, and writings inspired other women to want to birth naturally and to breastfeed.

Groups like the American Society for Prophylaxis in Obstetrics (that became ASPO Lamaze, and is now today, Lamaze International), and the International Childbirth Education Association (that spawned Doulas of North America) plus the mother of all breastfeeding organizations, La Leche League (now La Leche League International, a NGO at the World Health Assembly) together created a social movement around childbearing and mothering. Pioneers like Mavis Gunther, the 7 founders of La Leche League (Marian Thompson Mary White, Mary Ann Cahill, Edwina Froehlich, Mary Ann Kerwin, Viola Lennon, and Betty Wagner) Niles Newton, Kittie Frantz, Chloe Fisher, Suzanne Arms, Diony Young, Sheila Kitzinger, Jean Leidloff, Jeanne Parvati Baker, Raven Lang, Karin Cadwell (first heard in 1978)  and more, were all inspirations to me, as I became of childbearing age in the 1970s.

Before the 1940s and 50s, natural labor and birth and breastfeeding were mostly discouraged by doctors and lost to women. By 1971, less than 20% of US babies were breastfed at all. The re-birth of women’s power in mothering was helped by the consciousness raising movements of the 1960s, when women’s knowledge of birth and babies was discovered and shared with a contagious passion.

How have we gotten to a place where women are encouraged to through their milk away? As always, history gives us insight.

In the 19^th century, the Industrial Revolution led to people leaving their villages to go to the cities where factories paid workers. World Wars I and II gave women power and skills to run farms and factories in larger numbers than ever before. Someone else had to feed the babies so mamma could work because daddy was at war. Someone had to give a new mother advice about her baby because she was far from her family and friends; the new formula industry and the new profession of pediatrics were happy to be of service. Formula replaced breastfeeding and pediatricians replaced a mother’s network of female friends and relatives. This was considered to be progress, a good thing. Incidentally, this attitude fostered the growth of a new industry with a guaranteed market because babies have to be fed. If mama wasn’t breastfeeding, she had to buy or make formula.

Since the early decades of the 20^th century, the US has been a bottle-feeding, formula feeding nation, when the new profession of pediatrics married the new formula industry; this was helped by the invention of latex that made a flexible washable bottle teat possible. Replacing human milk with a manufactured product was also encouraged by science, because breastfeeding was thought to transfer germs between mother and baby. The war on germs started around the same time; only today, with research about the importance of the microbiome are we learning how serious were those errors.

After 3 generations of bottle-feeding formula, people didn’t know much about human lactation; they did know a lot about bottle-feeding and about feeding dairy cows. When breastfeeding was rediscovered, it was taught the way bottle-feeding looked and worked. Human lactation was thought to work the way that cow lactation did.   Mama was responsible for attachment, holding, positioning, and timing; no on thought that babies could do much. Breastfeeding teaching of the 1970s, 80s and 90s was the best for its time, and is totally different from what we’ve learned in last years of the 20th century and the early 21st century. The biologic template with both birth and breastfeeding still seems, after 600,000 years or so, to still be the best way for most.

Helpful hints to help breastfeeding:

Here are some ways we can help healthy mothers breastfeed their healthy, term babies. (Babies that are premature or sick need special care along with breastfeeding or mama milk.)  Use these hints when teaching pregnant women and when working with new mamas; they come from my decades of clinical practice, education, and teaching.

• Babies put something in their mouths as often as adults do. All humans put something in their mouth when they are hungry or thirsty, upset, enjoying eating, wanting comfort or pain relief, or partying.

• We all eat the same way, adults and babies. We take a sip or a snack,  have a meal, or have a restaurant meal or party. (Isn’t a restaurant meal or a party a feeding cluster?) A newborn that will double its size in a few months, needs to breastfeed when it wants. Using a schedule to feed a baby gets in the way of easy breastfeeding. No adult would deny themselves a drink if they were thirsty, yet it is common practice to deny a baby the breast unless it is the right time.

• Newborns can breastfeed during sleep because it is a reflex driven activity. Adults can’t eat in their sleep.
• Newborns will have all 3 eating patterns in one day; adults eat party style only at special times, like birthdays and holidays.

• Mama and Baby each have a role in the breastfeeding relationship.  Breastfeeding is love, entertainment, joy, medicine, and pain-relief.
  • Babies ask to breastfeed and then latch-on and drink.
  • Mama pays attention to baby, makes the milk and puts baby to breast when it asks.
  • When we make it easy for babies to do what they are born to do, everyone wins.
  • Laid-back breastfeeding is a easy way to start. Side-lying is also easy, as mama doesn’t have to hold anything.

• A breastfed baby may or may not need to burp. Regular burping is for bottle-feeding babies.

• A breastfed baby can be fussy because they need to move and stretch or because they need to be cuddled. Babies expect to be near a human heartbeat for most of the time. They are unhappy otherwise. They get cold, even when double-wrapped in blankets with a hat on. They get lonely. A dancing baby that kept a pregnant mama up all night won’t be happy for long unless it has space to move and stretch. A blanket on the floor is perfect.

• Formula contains MSG (not on the label) that many adults won’t eat because MSG can cause headaches; a formula-fed baby might have a headache and be fussy as a result.

• Breastfeeding is a relationship. It more than food and drink. Breastfeeding is love, pain-relief, entertainment, joy, and medicine.

• Breastfeeding is different to nipple sucking. Breastfeeding is a relationship between the baby, the breast, and the mother. Baby takes a big mouthful of breast. Baby has a tiny mouth on a bottle.  Mama can be doing other things while she is breastfeeding.
  • Bottle-feeding is about getting milk through a nipple; mama has to work at every feed to make it a heart-centered interaction, and to give baby control over what it drinks.

• A baby that can’t breastfeed is a baby that is in trouble. A baby that can’t breastfeed needs to be seen by a healthcare professional that knows about breastfeeding. Eating is like breathing for a baby; we would never say “Oh your baby is too lazy to breathe now, we’ll try again in an hour.”

• Babies can be bottle-fed through problems that won’t show up until the child is older and the problem is more difficult to fix; an example is cheek, lip or tongue-tie that may lead to weaning to bottle-feeding, and then shows up as dental or language problems after starting school.

• Mothers and babies have to figure out how to fit together comfortably so that breastfeeding becomes easy and fun. This can’t be taught with apps, lists and words. Seeing it as a child is the best way to learn breastfeeding, just as we learned about driving by riding in cars when we were children.
  • Giving a baby doll that comes with a bottle teaches children that bottle-feeding is the way to feed babies. Making mothers hide when they are breastfeeding outside their homes teaches children that babies are fed with bottles. Those children will grow up with the idea that breasts are only sex objects and fashion accessories, good for selling beer and boats.

• Pacifiers are for when mother can’t or won’t breastfeed. They don’t help newborns grow. Like a piece of gum that may distract from hunger or thirst for a moment, pacifiers are for temporary use at home when mamma can’t get to baby, as when driving. Pacifiers can bring ear infections.

• Adults love kissing and often spend hours doing it; babies love breastfeeding just as much, and they get milk when they do it! YAY!

• Breastfeeding takes time to learn. A mother won’t be doing it perfectly the first time, or the 16^th. Her milk volume may not increase until she gets home from the hospital. That first week or two is a wild ride, as baby recovers from labor drugs, mother learns to deal with a new world, and breasts change in shape and size every day. What new mothers need is someone to clean her bathroom, to take care of her other children for a few hours a day, and to make her dinner so she can recover from birth and get breastfeeding in the groove. The culturally acceptable 40 days is a nice length of time to exempt a new mother from any work, except that which she chooses, and for her to get breastfeeding in the groove.

• Breastfeeding has to be taken on faith. The baby shows that it wants the breast. Mother responds, and puts baby to breast. Baby attaches and suckles for a while and lets go when it is done. What has happened? The mother can’t see how much baby got; we have to teach her to look at what the baby does for her answer. Baby will show her that it is done by letting go of the breast, and smiling or sleeping, farting, peeing and pooping, and asking for the breast a minimum of 8 times a day.

• For how long is baby done? Who knows? You could drink a big glass of water, and be thirsty ten minutes later. Keep baby close and pay attention.

• The full-term healthy baby knows what to do. Mothers get confused when they pay attention to all the others: midwives and doctors, family and friends, lactation helpers and nurses. Baby will always give her the right answer to her question. Her baby will teach her to breastfeed. She has to keep baby close and pay attention.

• No need to sit upright to feed baby, as with a bottle. Slump and slouch a bit, get comfortable, and let baby do it.

• When human milk can have 16 to 50 calories in one ounce, knowing how many ounces baby got at one feed doesn’t mean anything.

• A baby has to reach out with its tongue and take a mouthful of breast. No shoving or stuffing of the breast into baby’s mouth will work for long. (Stuffing works only with bottles.)
  • When the back of its head is shoved into the breast, baby pulls its tongue back to protect its breathing. What restaurant has the waiters shoving customer’s heads into the soup?

• What the cow eats is very important for its health and its milk. Humans are different to cows. Humans eat all different kinds of things. Mamas can pretty much eat what they want. It is best to eat strong food so that Mamma keeps all her teeth and pretty skin and has good energy to be mothering a baby human, one of the hardest jobs on earth. Strong foods are fresh fruits and vegetables, whole grains, protein (beans, eggs, and meats) and fresh water.

• Pregnant moms start making milk about the time they feel their baby move. Formula arrives (“comes in”) at the store when the truck makes a delivery. The store can run out of milk. Mama doesn’t.

• How many minutes a baby breastfed says nothing about how much milk baby got. If you tell me that you ate lunch in 10 minutes, do I know how much food you ate?

• Babies use their hands to eat, just as all humans do. Swaddling a baby to feed it works with bottle-feeding, and makes breastfeeding difficult.

• Healthy term babies want to live. That means asking for the breast when they need it. A baby that is asking to go to breast at least 10 times a day, is smiling after feeds, is farting, peeing and pooping, is mostly content, and starts gaining weight when its poop turns yellow is a healthy baby. Babies don’t pretend to be fine to make their mothers feel better.

• Trust the baby. Fun is part of health.
  • A mother who never has any fun with her baby is a sign of a disturbance in their relationship.