Still smiling from the aptly-named Positive Birth Movement meeting last night, I went to the hospital this morning to begin training to deliver the '11 o'clock stop' information to mums on the postnatal ward.
As I've mentioned before,this is something I've been super-keen to get involved in for the last 3 years. You know when you've hoped for something for a long time and it finally happens? And you're slap bang in the middle of the action, right where you want to be? That's exactly how I felt as I sat in on the delivery of this information to a small collection of mums and dads in the day room.
The information was not new to me, as it's the kind of knowledge that I pass on to mums in community and hospital drop-ins every week. Passing it on in these very early stages can make all the difference to the early days of breastfeeding, where simple lack of information and knowledge is enough to derail the whole thing before it's even had a chance to get going. As always, but especially with women who have birthed in the last 24-48 hours, the volume of information is kept to exactly what is needed, because when you've just birthed a baby, the instinctive part of your brain is working and the part which takes in information is easily overloaded.
We spoke about frequency of feeding, sore nipples, night feeding and tiredness, as these are the things most likely to result in parents offering an artificial feed or two to reassure themselves that their baby is getting enough milk.
Artificial Feeds and Low Milk Supply
This is one of the commonest ways that breastfeeding gets sabotaged early on, and that is because breastfeeding it is a hormonally-driven demand and supply set up. Therefore it follows that if your baby is busy sucking on a bottle, he or she is not draining milk from your breast and therefore not putting in an order to the body to manufacture milk for the following feed. During the artificial fed, if you don't pump or express, your breasts will remain full of milk. If they stay that way for longer than a few hours, the pressure of the milk in them, and other mechanisms, produce a protein called Feedback Inhibitor of Lactation or FIL for short. FIL does as it says on the tin and feeds back to the brain to stop milk production for now.
So the following feed when your baby goes to the breast, she may well appear unsatisfied for real because the milk isn't there. So another artificial feed is given...and you can see how it plays out. Artificial feeds quickly go up, breastfeeds become less, resulting very quickly in loss of milk supply.
This is a damaging scenario for establishing a full lactation, especially if it happens in the first two weeks after birth. During these first 14 days, the stimulation of regular suckling ensures that prolactin receptors (prolactin is one of the main hormones of breastfeeding) are laid down in the breast. This happens for each pregnancy and lactation a woman has. If her breasts aren't sufficiently stimulated during the first two weeks of her baby's life, a woman may not reach a full lactation.
I've often heard of women, and heard women say, that they couldn't breastfeed their baby because they 'didn't have enough milk'. The number of women who can't produce enough milk as a primary situation is very low. Your body has been able to assemble and grow an actual new human, producing milk to feed that human is what naturally comes next! Nature's design is not going to waste that nine months of effort and growth when it comes to feeding the baby. The small number of women who can't produce milk, have one of a number of specific medical (usually hormonal or mechanical...due to injury or surgery) reasons why. The reason for 'not enough milk' is usually the scenario described above.
I see this very often in clinic. It can be devastating to discover that the reason you aren't lactating fully is because you doubted your body in the first place when all was probably happening as it should. This is the reason I'm so keen to get on to the wards and get the right information where it's needed, before doubt and artificial feeds creep in unnecessarily.
If you're caught in the downward spiral of artificial feeds and low milk supply, get along to a drop-in clinic or see an IBCLC or breastfeeding counsellor as soon as you can. You can telephone the postnatal ward of your hospital and ask for a visit for breastfeeding support if you're still in the early days.
The advice may well be to use a hospital grade electric double pump (you can hire these) and pump between feeds, so that your breasts are being stimulated at least 10-12 times in 24 hours, at least once at night. There may well be other things your healthcare professional will advise you to do.
These helplines are available if you need to speak to a breastfeeding counsellor in the UK:
ABM 0300 330 5453
NBFH 0300 100 0212
NCT 0300 3300 771
LLL 0845 120 2918