Thursday, January 18, 2007

If breastfeeding is natural...

"...then why is it so hard?"

A question many people ask, and frankly I don't have answers to. My own experience breastfeeding has been flawless. Can I attribute that to good luck? good karma? good boobs? good education?

I did educate myself a LOT about breastfeeding before I gave birth. I read Jack Newman's book The Ultimate Breastfeeding Book of Answers twice, and watched several video clips on his website to know how to get a proper latch, and what it should look and feel like. I also had a completely uninterrupted third stage and was able to breastfeed immediately for as long as Zari wanted to.

However, I know many women who have similarly prepared themselves, had fantastic unhindered births, and then had tremendous difficulties nursing--baby losing weight, painful latch, bleeding nipples, you name it. So to say that education and preparation will ensure a smooth nursing relationship is obviously too simplistic.

We could ask the same question about giving birth, actually: if giving birth is natural, why is it so dysfunctional today? Why do over 30% of women have cesareans? Why are so many women's labors induced or augmented?

Do you see parallels between breastfeeding and giving birth? What accounts for the high rate of "failed" or struggling breastfeeding? Let's discuss!

11 comments:

  1. This is an interesting thought. I really can only go by my own experience, and it has gone like this:

    1st baby (Joshua) - I was moderately prepared for my home birth, however, I submitted to, and actually encouraged several interventions that made my experience go really sour. I was induced LOOOONG before my body was ready to go into labor, and so experienced an incredibly long, drawn-out labor that was extremely painful. I suspect that this was probably because my baby was not ready to come out yet, and so he did not make the process any easier. Hmmm...maybe that is why he is so stubborn now. Interesting thought.... Anway, I bled heavily after the labor, and was very weak. Even so, I tried to jump right up and be Super-mom immediately. Never mind the fact that I had hemorraged for two hours after the birth, or that I had been on total bedrest for 4 1/2 weeks prior to the birth. I tried to do it all immediately. I even remember taking Josh to the health department when he was 3 days old, and refusing the help of my mom because I wanted to do it myself. How dumb could I get? I had a really hard time breastfeeding at first. Josh latched on wrong, and ended up sucking blisters onto the tips of my nipples, blisters that then burst. This was incredibly painful. I also got painfully engorged because Josh wasn't able to suck properly. Finally, when he was a week old, I sought help with his latch-on and rented a pump so I could get regulated. The whole process took about two weeks before I could nurse without my toes curling. After that, I didn't have any trouble. I ended up nursing Josh for 21 months, and made straight cream for him the whole time. :) BTW, I did experience months of PPD after this birth experience, and it took me a long time to process it

    2nd baby (Matthew)- I had this baby in the hospital, though not entirely by my choice. We were living with my mother-in-law while we built our house, and she was NOT okay with the idea of a homebirth in her home. I didn't know enough then to realize that there were other options. Now I do. The labor was much shorter, and not nearly as painful. It was still a lot of work, but a much better experience than the first one. Matthew's birth had no complications, and though we had a tough time bonding at first, (I chalk that up to the incredible stress we had endured with Josh's health problems and the guilt I had burdened myself with.) we had a pretty good nursing experience. I still got painfully engorged, but everything went better. I must point out here that there were some serious stressors here. We were living in somebody else's house, and so did not have any real privacy. I was very sensitive at the time to outside criticism, and was not very healthy so I didn't feel very good. I had a difficult time bonding with Matthew right away, and also experienced serious milk supply issues when I tried using the patch as birth control shortly after his birth. Another "what was I thinking?" All in all, this was not an ideal experience, either.

    3rd baby (Benjamin) - This birth was incredible. I labored off-and-on for two days, but it was never anything really big. By the time my water broke, I had begun focusing and breathing, but I had not even broken a sweat yet. We had made the decision to have this baby in the hospital, though we had wanted him to be born at home because when my husband lost his job a few months prior, we also lost our insurance, and so did not have the ability to pay for a home birth. If I had known there was such a thing as UC, things would have been different, but I didn't so oh well. When my water broke, my doula immediately insisted that we go to the hospital, and so we got in the car to begin the 25 minute trip. I started feeling pressure within minutes, and when I reached inside to see where Ben was, I discovered that he was rapidly making his way down the birth canal. Jon, our doula, and I started praying that there wouldn't be any more contractions because I wasn't so keen to birth in our brand-new-to-us van. When we got to the hospital, I managed to get into a wheelchair, though Ben had already crowned. His head was born in the elevator, and we made it down the hall and around the nurse's station, and almost to the door of my room before Ben was born. The labor (once it got going) was very fast and almost painless. It was over so quickly that I wasn't even emotionally ready for him to be there yet, seeing as I was used to hours of labor and lots of work to birth my babies, though it was incredibly exhilarating. It was amazing! The after effects were even better. I bonded immediately with Ben, and felt absolutely happy and at peace. He nursed like a pro, and we never had a latch-on problem. My milk came in within a day-and-a-half, but I never engorged. I got full, but never painfully so. It was incredible. Though we had the stress of Jon being out of work, none of the stressors from before were there. We had plenty of peace and quiet, and I didn't not try to be Super-mom. I was healthy and felt great, and I really think that enabled me to have a much better nursing experience.

    I know this has been a long, drawn-out story, but here is the gist of it. I feel that the outside stressors in a mother's life have a DIRECT correlation with how much she trusts her body and how well the labor goes. I feel that if a mother is stressed and worried, then that sends a message to the baby that the world outside isn't safe, so it's best not to come out. This can make labor into a long, painful experience at best, and at worst, a horribly traumatic one. On the other hand, if a mother is able to birth in a peaceful, quiet setting and feel that her body is capable of doing what it needs to do, birth can be a life-transforming experience that leaves a mother with intense feelings of satisfaction, exhilaration, and elation. I really feel that breastfeeding, at least at the beginning, is directly correlated with how well the birth went, and how the nother feels about herself and her baby.

    Okay, this was basically a post in-and-of-itself, but there it is.

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  2. jen.b.in.az1/18/07, 7:12 PM

    My short-and-simple explanation is that both birth and breastfeeding have been so medicalized that people don't approach them as natural, but rather expect problems. Not meaning to sound callous, but it seems people assume there are options for both (no pain birth, formula feeding). If you approach either with the thought that you don't have to "succeed," it is easy to just go the modern American mainstream way. I'm not sure if this really is making sense...um...in my personal experience, I never once thought that my non-hospital births would be anything but simply births. I never thought of pain meds, I never thought that I needed anything else (and their births were both very fast). Same with nursing my kids: it never crossed my mind that there was any other way to feed them, so nursing simply WAS. I know people will probably argue they felt the same way, and maybe I'm completely wrong, but from everything I hear others say, there's too much thought put into both processes, and I swear that interferes with the natural processes. Maybe kelley said the same thing in different words: a stressed mom sends the wrong signals to the baby, and the processes are messed up. The way most Americans approach birth and breastfeeding IS stressful.

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  3. Jen, I agree that having options makes it easier to give up. Before there was artificial feeding, you HAD to breastfeed (unless you were rich enough to hire a wet nurse, I guess). A woman had to find ways to overcome any breastfeeding difficulties. I imagine that the social support network for birth and breastfeeding was quite different, too. Giving birth successfully and breastfeeding weren't options like they are today--they were vital for survival. My hunch is that communities, as well as individual women, were much more invested in ensuring that survival.

    History according to Rixa?...

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  4. Hmm...not sure where to start on this one. My first birth (Gage) was a complete intervention nightmare. I was traumatized severely and to this day still have bonding issues with my son. The hospital basically held him hostage and refused to let us take him home until he was taking 3 ounces of formula every 3 hours. It took my milk 7 days to come in after the c section and when it did I still couldn't sit up or move on my own from the surgery, was painfully engorged, and had a fever from it. I never really caught up but managed to mostly breastfeed him with just formula at night, but at 5 months my milk went away and I was unable to get any help or figure it out.

    My second baby (Logan) was a complete UP and UC, a wonderful experience. I nursed her for two hours immediately after the birth and was thrilled on day 3 when I had an over abundant supply of milk coming in. Then the same latch problems with my son began, cracking, bleeding, blisters, crying, screaming...all of it. My daughter lost weight. Anyone who reads my blog can follow the progress but basically the latch issues went on so long that at her one month check up she weighed almost a pound less than her birth weight. At 7 weeks old she is still not at her birth weight but has been gaining well since we corrected the latch problem. For the most part nursing is great now but I'm not sure about the correlation between birth. I feel like I did everything possible to give her the best pregancy and birth and still had problems. Though thankfully I was never tempted by formula this time around, I actually went against medical advice, of course, and refused to supplement with it and instead worked to get more pumping and gave her my own milk.

    I suppose I'm losing sight of the original question since I'm very tired as always, but that's been my experience so far.

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  5. I think breastfeeding is all about the baby. It was a nightmare with #1--we did it for 6 months but my baby never enjoyed it. She didn't have a proper latch until she was a couple of weeks old and preferred anything to the breast--solids, cup, bottle, etc.

    Baby #2 knew how to do it from the start, no problems at all, only weaned because the milk dried up at 14 months. Of course, I thought, it's because I'm experienced and know what I'm doing!

    No. Baby #3 didn't latch on properly until day 3, and we struggled a lot to get breastfeeding established. And then he liked it so much he shuns food.

    I see a lot of my kids' personalities reflected in their approaches to breastfeeding. Child #2 has been easier and less opinionated about everything, and far more willing to try new things. And all of my births were easy--the recovery from #1 was more painful, of course, but the others were a piece of cake. I don't see a connection between birth and breastfeeding.

    However, I have several friends who were dreadfully sick while pregnant who just couldn't make enough milk for their babies despite trying everything. So I think there is a correlation between rough pregnancies and milk production. I've noticed a dramatic (temporary)drop in my milk production when I've had a fever or been ill.

    So, my experience with breastfeeding has been, maybe 10% of mom (experience and education) and 90% baby. Kind of gets you ready for motherhood in general, doesn't it?

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  6. I think stick-to-it-iveness and support are the two biggest and most important factors in a successful breastfeeding relationship.

    I had all the usual problems: baby not latching, baby not latching RIGHT, cracked nipples, raw nipples, dwindling milk, clogs, you name it. But I was determined to make it work. Giving up didn't even occur to me. I think too many women are too willing to just quit when the going gets tough. Of course, they have the right to do that, but it's so sad that this happens. Would you quit riding a bike the first (or third or eighth) time you fall off? Breastfeeding is a SKILL and it must be LEARNED. It took me quite a while to master it, and just when I thought I Had it all figured out, something else would get thrown at me. But I would work to overcome it, because I WANTED TO BREASTFEED. Women who really, truly, want breastfeeding to work need to be strong and not quail in the face of what looks like failure. One of the most pro-breastfeeding women I know, who is also a lactation consultant, has had so many problems nursing that it makes me squirm to think about them. But she didn't give up, and her toddler is still nursing today at 3+.

    Good support is also key. It sucks that so many women either get no support or they get totally crappy advice whenever a breastfeeding problem arises. It makes me want to cry whenever I hear about a friend who was told her "milk was drying up" when her baby couldn't latch on, or that her milk "wasn't good enough" when her baby wouldn't gain weight. My own grandmother even told me that breastmilk was "sapping all my strength" and that I needed to put my son on formula so I could "get healthy again." But good advice is even more important than ignoring the bad advice. My LLL nurse just handed me a nipple shield when my son wouldn't latch on, instead of trying to help me correct his latch. It took me two months of struggling to get him to nurse without it until I talked to a friend who taught me the "C" hold, and I was finally able to throw that damn shield away. The LLL can be great, and every woman should consider them a resource, but they are not always the best people to give advice.

    This is getting kind of long-winded, so I guess I should shut up now. :) I also want to add that the ready availability of formula can really quench the urge to keep trying....as soon as an issue arises, there's that handy can of formula that the hospital gave you, sitting on the coutner. I myself have had to rely on formula (once when I was hemorraging a week after birth and my baby had to go to my MIL while I went to the ER, and again when I was having such a horrible time with raw nipples at 7 months old that I cut out direct nursing altogether and just pumped and gave formula for about a week), so it can be a godsend in an emergency, but I think it gets relied on way too much.

    -Jill

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  7. I think the biggest reason that breastfeeding is so complicated, is because we don't have a continuum of female breastfeeding support. Sure, you can read books and watch videos, and be really well prepared, but NOTHING compares to seeing women breastfeed around you all your life. I was breastfed, I watched my mother breastfeed my brother, I watched the ladies in my church breastfeed their babies, and I watched my friends who had children before me breastfeed their babies. I knew that I could count off any number of people, including my own mother, who could help me figure out if something was wrong, day or night. I think that THAT is what is missing- growing up around breastfeeding women- seeing them do it, not being ashamed of it, listening to them talk about it, and then using them for support when your own time comes. LLL plays that role in today's society, but it's growing up around it, seeing it as normal that helps the most I think. Breastfeeding is a *learned* behavior. It's natural, but that doesn't mean it comes naturally. And I don't mean that women won't have problems if they have that support, but that the small problems can be fixed before they become large problems, and large problems will have the benefit of lots of ideas, lots of "oh, I've been there"s, and lots of support.

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  8. well first off I wanna say that sometimes the best things in life are the ones that we have to work hard for. As much as I wish noone ever had a problem Bfing, I also realize the triumph that comes from having problems and working thru them.

    I have had many prolems BFing my children. I never had a latch problem! I had a very weirdo problem of making too much milk - so much to much my kids would vomit continually and I was hurting thru the entire time I was BFing. you know that engorgement that some pple get at the beginning? I was like that the entire time. The irst 3-4 mos were almost unbearable. to say it was painful is an understatement. my 2nd had a sensory disorder and after 6 mos refused to eat anything breastmilk or not. this was a continual battle with LC's and books and doctors and nobody has an answer. it wasn't my body's issues but hers. I knew A LOT about BFing then. and now I know even more (I'm working as a doula right now) and I can turely say I know I didn't do anythign wrong nor could I have done something better. It was weirdo things that can't be controlled or changed. but you know? I'm very proud of how much I went thru to give my kids breastmilk. sure i wish it would have been a breeze, but I know how much love it takes to keep on BFing thru these struggles. or even to attempt to. It has made me who I am and taught me what I know.

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  9. "I think the biggest reason that breastfeeding is so complicated, is because we don't have a continuum of female breastfeeding support."

    I fully agree with anonymous' whole post. I had an easy (home)birth with a great midwife and feeding's been a breeze. I don't know why, though, and as it's my first (a very easy, happy baby by any standard) I can't compare. Interesting to hear all these stories, though.

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  10. I get the same question all the time why is it so complicated, or difficult...I thought the same with my first two and had a horrible time as the advice I was being given was rubbish, since then I have had fabulously easy experiences after doing exactly what you do with preparing myself... I think the biggest thing I found was that when breastfeeding becomes too complicated or difficult it should be the first sign that something isn't right, rather stopping breastfeeding mums need to uncomplicate and try to figure out what is making it so difficult its usually bad advice and poor latch. Breastfeeding is effortless and a pleasure when its not your not doing it right, at least that is what I have found.

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