Many years ago I was asked to visit a new mother having trouble breastfeeding her baby. Not having much experience, I called a colleague for advice. The instructions she gave me for the mother went something like this: Sit in a straight-backed chair, with a pillow behind your back. Rest your feet on a thick book on the floor, so your knees rise above the level of your hips. Place a pillow on your lap to raise the baby to the height of the nipple.
And that was only the beginning.
In earlier generations, no one had to explain to mothers how to feed their babies. Women grew up seeing their mothers, aunts, cousins and sisters breastfeeding. But once formula feeding became prevalent, nursing mothers lost their role models, along with their confidence. Instead of being natural and pleasurable, breastfeeding seemed difficult and technical.
Dr. Christina Smillie, a pediatrician and International Board Certified Lactation Consultant, recently visited Israel to give a series of lectures. On the first day, she shared her early experiences helping mothers whose babies weren’t breastfeeding. She noticed that most babies, when placed near their mother’s breast in a supported position, started to nurse on their own. As she worked with more mothers she realized that “left-brain” instructions—logical and structured–didn’t help. The instructions interfered with an instinctive “right-brain” process.
When she meets mothers Smillie suggests that the mother lie in a half-reclining position, with the baby placed on her stomach or chest. The baby can lie at any angle. She showed several videos of babies who suddenly began breastfeeding, surprising the mother who hadn’t known that the baby could do it. She has also produced a video for new mothers.
Smillie lists four points to keep in mind when putting a baby to breast for the first time:
How Babies Learn to Feed:
- First, a calm baby
We don’t make a baby learn to feed
We allow the baby to follow his own instincts to learn
- Baby, not mother, initiates feeding
Mother follows baby’s lead
- Seeking comfort guides the mother
- Instincts start the process of learning
It is the successful transfer of milk that teaches the infant.
Move from an instinctive process to a learned process.
[© 2011 Christina M. Smillie, MD. Reprinted with permission.]
Smillie emphasized again and again how the mother and baby instinctively know what to do. Without being prompted, the mother often begins to stroke or talk to the baby. The mother adjusts herself, the baby, or her breast. The baby is not helpless, either: They are born with the “stepping” reflex, which helps them crawl to the mother’s nipple and take the breast, and have more control of their head than we generally give them credit for. There’s no “right” position for breastfeeding as long as everyone is comfortable.
Breast Refusal: A Learned Behavior
But what about a baby who cries when placed on the mother’s chest? Smillie explained that this is usually because the baby has developed a negative association with the breast. A mother generally tries to calm a crying baby. When the baby cries on the right shoulder, she transfers the baby to the left shoulder. If that doesn’t work, she gets up and walks around. But when the baby cries at the breast, the mother often keeps trying—in other words, she doesn’t respond to the baby’s distress. The baby quickly learns that this is a place where mommy doesn’t give comfort. After a few minutes of trying to breastfeed, the mother offers the bottle and everyone relaxes. So the baby associates the bottle with a relief of tension.
The next time the baby cries when put to the breast, the mother interprets the baby’s behavior as a preference for the bottle. But the problem is simply that the breast has been a place where the baby’s need for comfort was not met. Many babies have been “shoved” on to the breast at some point, which can cause or exacerbate the problem.
If the baby has developed an aversion to the breast, Smillie usually recommends that the mother express milk for a few feedings or days, while gradually making the breast a comfortable place again. Babies have short memories. She finds that babies whose mothers have never offered the breast take it more easily at older ages, because they have no negative association.
If you are a mother, what helped you learn to breastfeed? What didn’t help?
You may also enjoy: