Baby-led breastfeeding

One of the best parts of my job is when I get to watch a baby find its way to the breast. Its just magic! It can make me shed a tear. But what’s truly upsetting to me is the fact that many mothers do not get to experience this, purely because no one has told them about the phenomenon of baby-led attachment.

Here is a quote so powerful in its truth:

Babies breastfeed and mothers make milk

I can’t remember who said this (if you know please tell me so I can credit them). Often this is forgotten, all the responsibility is placed on the mother. She feels that burden. But what if we gave some of that responsibility back to the very capable infant and set the stage for success. Babies breastfeed – lets give them the controls. It could be said that a baby’s instinct is much stronger than its mother, whose intuition has been withered away by a culture that has fostered a loss of primal knowledge replacing it with doubt and fear. A society that lacks confidence in women and their bodies. If we can’t trust our bodies, let us at least trust our babies.

If you place a baby prone on her mother’s chest (mother is reclined and baby is lying on top – chest to chest), like any other mammal she is wired for survival and will use her innate reflexes to find and attach to the breast. This instinct exists for a couple of months, and is a great technique to try when experiencing breastfeeding difficulties. Some babies initially resist a conventional mother-led breastfeeding position, perhaps due to birth trauma/pain, over stimulation etc. It is especially useful for that first feed, when baby is placed skin to skin on the mother immediately after birth. A natural progression. In fact the first breastfeed could be considered the “4th stage of labour”.

The World Health Organisation (WHO) states that:

“the process of childbirth is not finished until the baby has safely transferred from placental to mammary nutrition”.3

Most babies can find their own way to the breast within an hour. Routine procedures can wait for an hour or so, and any observations of the infant can be done on the mother (the baby’s natural habitat).

It is important for mothers to know that labour medications and epidurals (used in vaginal birth and caesareans) may interfere with baby-led attachment. It is striking to see such dulled reflexes in some babies; no rooting or gaping (turning towards the breast with the mouth open wide); no nibbling;  which may persist for days resulting in increased stress for the mother and the need for formula supplementation. Often mothers aren’t told about these deleterious effects on early breastfeeding.  This information is essential for mothers to make an informed choice.

Unfortunately the routine practice of uninterrupted skin to skin is not yet commonplace and some midwives have never heard of baby-led attachment. This may mean pregnant women need to ask for it. In order for change to occur there needs to be a demand. It can be difficult for first time parents to challenge the status quo in hospital (as a consumer parents do have the right to speak up) alternatively hire a doula (or me!) to do this for you. A doula is trained to be a woman’s strong supportive voice (and much, much more). I still regret not hiring one for my first birth.

Mothers also need to be aware that choice of birthplace can make a significant difference to breastfeeding success . Choosing a hospital that is baby-friendly accredited will help to increase breastfeeding success. A baby-friendly hospital adheres to the “Ten Steps To Successful Breastfeeding”. Step 4 is:

“Place babies in skin-to-skin contact with their mothers immediately following birth for at least an hour and encourage mothers to recognise when their babies are ready to breastfeed, offering help if needed.”

As a health professional I have to force myself to be hands off. There’s an urge to interfere, to help the baby get to the breast. But if we can be patient, so much can be gained. This sacred space cultivates a mother’s confidence, breeds trust and starts the captivating process of bonding.

Suggestions for pregnant mothers who wish to breastfeed:

  • Attend an antenatal breastfeeding class. The Australian Breastfeeding Association covers baby-led attachment in their classes.
  • Choose a BFHI accredited hospital for your place of birth.
  • Hire a doula or take a hypnobirthing class. Both options have research that shows a reduced need for analgesia and birth interventions.
  • Ask for skin to skin after birth (and an uninterrupted first hour).
  • Try baby-led attachment – trust your baby knows what to do, even if you don’t.