Prepare: The Learning Curve of Breastfeeding
By Danielle Rigg, JD, CLC
© 2008 The Best for Babes® Foundation. All rights reserved.
One of the biggest keys to succeeding at breastfeeding is to set your head for a learning curve experience. Learning to breastfeed is no different than learning to swim, knit or sing: there may be bumps along the way, but keep your eye on the prize and before you know it, you’ll be doing great! Unfortunately, many new moms set themselves up for disappointment by expecting that breastfeeding will come “naturally” — “how hard can it be? Women have been doing it for millennia” –or they expect it to be painful and difficult because they have heard stories about how hard it can be. The truth is neither. The truth is that although breastfeeding is instinctive, it is a skill that both mother and baby have to learn and master. This is what we call the learning curve of breastfeeding and it usually takes about 4-6 weeks.
To use the sports analogy again, if you decided to take up running, you would expect to get sore muscles, but because you know that it’s part of the experience, you would take it in stride and not let it derail you. Unfortunately, because our culture fell off the breastfeeding wagon (don’t forget that only 20% our parents breastfed in the 60s-70s), we have lost a sense of what to expect and our definition of “normal” and “natural” has become warped. At the same time, targeted efforts to undermine breastfeeding have put roadblocks in the way of women succeeding. The unfortunate result for too many women is that their first race is uphill with hurdles, often depending on where you give birth or what part of the country you live in! So be gentle with yourself and your baby during this time—you both are learning a new skill and a new relationship. And really, 4-6 weeks is a small period of time compared with the lifetime of benefits for both of you!
Finally, don’t compare and despair: there are some women for whom breastfeeding comes as easy as golf comes to Tiger Woods. Whether by natural talent, or because they were lucky to have fewer breastfeeding booby traps™ in their way, these women had no problems breastfeeding and have difficulty understanding why others do. They (or their friends or doctors) may end up coming across as a bit insensitive or invalidating towards you in the process. Don’t let this get you off kilter! Most people have not stopped to consider all the cultural and institutional barriers to breastfeeding and, therefore, have contributed to blaming mothers unfairly. Best for Babes is working to educate family, friends and professionals, as well as removing those booby traps™, so that new moms are no longer thrown under the bus and breastfeeding is restored to the “normal” and “natural” experience that it was designed to be.
Here are our key evidence-based concepts to get you off to a great start:
Practice Makes Perfect.
The good news is that your little babe has tremendous instincts which drive him/her to the breast immediately following birth — newborns can even crawl to the breast unassisted to latch on for a feeding! (see Lennart Righard and M. Alade, “Effect of Delivery Room Routines on Success of First Breast-feed,” The Lancet 336, no. 8723 (3 November 1990): 1105–1107). However, your little babe still needs to master the skill of milking and emptying the breast. And you, Babe, need to master how to latch your baby and how to read his/her hunger and satiation (satisfaction) cues–both of which are often frustrating feats in the first days. The fastest way to master a good latch is to exclusively breastfeed. This is because milking a breast is nothing like sucking (as in through an artificial (bottle) nipple or straw) – breastfeeding uses the baby’s tongue and jaw to compress and create a vacuum affect. The less you interfere with breastfeeding, therefore, (ie., no unnecessary separation of mother and baby, no scheduling of feedings, no pacifiers until breastfeeding is established, no supplements unless medically indicated, and then, only given by cup, spoon or syringe so as to avoid tampering with the baby’s latch), the more quickly you and your baby will ramp up to cruising speed and be problem-free. As leading breastfeeding expert and pediatrician Dr. Jack Newman likes to say, “Babies learn to breastfeed by breastfeeding!” (see www.drjacknewman.com for more excellent advice and information).Have Reasonable Expectations and Give Yourself Permission to Make Mistakes.
Although some lucky moms get a great latch from the get-go, most moms (at least in our culture) tend to spend the bulk of their learning curve experience working with their baby to perfect this skill. This is time well-spent because a good latch is a major key to breastfeeding success. Here’s some insider advice: In the beginning, it is not unusual to need to latch, detach, and re-latch your Babe over and over again. Really, it might take 10 –that’s right, TEN, or more– tries to get a latch that satisfies both you and your babe. Importantly, this is not a sign of rejection! Many moms misinterpret these trials as “my baby doesn’t want it!” and begin the downward spiral of dwindling confidence in her body’s and baby’s ability to breastfeed, aided and abetted by well-meaning but ill-informed hospitals, doctors, and relatives and peers. (Just in case you were wondering, women didn’t always have as many struggles with breastfeeding: women who are allowed to birth without medications, are allowed to put their babies to the breast immediately after birth, encouraged to wear their babies throughout the day, keep them close-by at night, and know to nurse them on demand, do have far fewer breastfeeding problems. In fact, in cultures where breastfeeding is the norm and supported at all levels, nursing is much, much easier!)Learning Doesn’t Mean Hurting.
We have heard droves of women repeat the myth that the first two weeks of breastfeeding are painful no matter what. This is not true! Sore nipples and pain are not an inevitable part of learning how to breastfeed!! Rather, sore nipples and pain are almost always a sign of a poor latch – and a poor latch is usually both avoidable and correctible! Letting a lazy latch continue is tempting to a new mother who has struggled to get the baby on the boob for 10 minutes and is not being given proper guidance, but it is a lose-lose situation: a shallow latch usually means that your baby isn’t able to get as much milk – which also puts you’re your milk supply at risk (the more they take, the more you make and vice-versa), solidifies your baby’s lousy latching habits making it a harder habit to break them of, and causes pain and soreness. So what is normal? Yes, your delicate, newbie nursing breasts may feel uncomfortable as they adjust to the unexpected sensations of baby breastfeeding (not quite like the titilation—pun intended—that got you knocked-up in the first place!) but that feeling should dissipate as the feed continues, and should be non-existent (or near non-existent) once your milk supply is established (a couple of weeks) and you near the end of the learning curve. If you feel true pain – pain that lingers beyond the first few moments of a feeding and you would rate as a 4 or more on a scale of 1-10, take your baby off the breast – carefully– and re-latch him/her. (Note: you don’t ever want to pull your nipple out of your baby’s mouth—ouch!—but, rather insert your pinky in the corner of your baby’s mouth and pull back toward his/her ear until you hear the seal of the latch break.) Better yet: make sure you see the hospital LC, or if she isn’t available or providing enough help, call an outside LC (see our section “Your A-Team”). Please take this advice seriously, it doesn’t take long (24 hours or less) to go from a little sore, to a lot sore, to “I can’t take it anymore!” –which is exactly what has undone a vast number of well-intentioned moms. Don’t let this be you! Sore nipples are usually a simple problem that can be fixed. Not attending to them is like letting a major leak in your pipes go unrepaired; eventually the damage can destroy the foundation of your house.Surrender and Ask for Help.
This is a biggie. The beginning of motherhood is a true test of surrendering – a time that requires you to focus on you and your baby and not much else. This can be a real challenge for most of us modern moms – especially if you have other children or, like us, were older, used to a very busy life outside the home, and reticent to ask for help. We understand! However, new motherhood is the perfect example of an “either let go, or be dragged” situation. You see, your main goal with a newborn is to not just to get him/her fed – but to get him/her settled—which means, satisfied, calm, nurtured and content. The best way to do that is by surrendering to the role your body and your baby need and expect you to assume for now – that is, the role of primary nurturer. The more you fight nature’s design, the less settled and content your baby will be—which can continue into toddlerhood and beyond — and the more irritable and tired you are likely to be. If this sounds too extreme for you, consider the fact that on a very real physical and psychological level, you and your baby are still one; cutting the umbilical cord does not mean your baby is ready to be separated from you. On the contrary, newborns and new moms are very much dependent on each other for optimal health. Just like kangaroo babies cannot live outside the pouch, human babies are born in a state of dependence on their mother – both for sustenance and development. Your milk literally completes the development of your baby’s immature digestive and immune systems by depositing critical antibodies, infection fighters and the like, and provides the perfect food for his/her still-growing brain. (See our section “Get Inspired by Your Mom-Made Wonder Food – Dazzling and Amazing Lesser-known Facts” for more). Your providing milk also does wonderful things for you, Babe. Breastfeeding contracts your uterus and gives you a flat stomach, protects you from obesity by burning 500 calories a day to lose your baby fat, shortens the duration of postpartum bleeding, suppresses ovulation and menstruation, provides surges of hormones that will calm you and help ward of postpartum depression, just to name a few cool benefits. If the idea of someone being dependent on you seems overwhelming, and trust us, we understand!—take solace from knowing that it is only temporary, and studies show that the more bonded and interdependent you are with your newborn, the more independent and emotionally healthy your child will be later on. So, put first things first and get other people to nurture you and help you – prepare meals, put water or juice beside you every time you nurse, clean up, do the laundry and shopping, babysit an older child– so that you are free to focus on nurturing your baby. If you are short on family or friends to help, think about hiring a doula—a woman who specializes in “nurturing the nurturer” (YOU)—and usually has significant knowledge regarding breastfeeding (you can find listings of certified doulas in your area at http://www.dona.org).Have a Supportive Loved-One By Your Side.
The learning curve period is a fragile time for you and your baby, a time when you need as much support as you can get from your spouse/partner. Studies show that spousal support, or lack of it, can make or break breastfeeding. (Littman, H. et. al., 1994: The Decision to Breastfeed: the Importance of Father’s Approval, Clin. Pediatr. 33[4]:214). The reality is that many moms—whether they are breastfeeding or not–“hit a wall” of some sort during the first few days, when they are exhausted and postpartum hormones are raging. This challenge usually strikes, by the way, at 3am on day 2 of your child’s life when your baby – who was previously sleepy from delivery, is now coming awake and getting hip to the whole nursing thing, and your mature milk may is not flowing yet. So, having a partner/spouse who is completely enrolled in and behind breastfeeding—and why we encourage them to attend a good breastfeeding class with you – is critical! You simply need someone beside you at 3am who will remind you about what you are reading now — that this is a learning curve, not to give up too soon, and, most importantly, give you a hearty and reassuring “you can do it!” (See our Section “Top 5 Breastfeeding Tips”). Your spouse/partner should be like the breastfeeding protector, weeding out shady advice, shielding you from snarky comments and negative influences, demanding a good lactation specialist if you need more help than you are getting, and commanding the troops to help you when you are home.See Yourself Successful.
A fabulous tool for ensuring your breastfeeding success (or any success for that matter) is to do mental imagery. You may be familiar with the concept of “think positive” or visualization—Michael Phelps is a testimony to what can be done by believing in yourself and believing it is possible! Mental imagery is an integral part of mind-body medicine, and is similar to those tools, but even more effective. (See http://www.drgeraldepstein.org for more wonderful tools and exercises for healing and wellness) It is also much quicker, lasting only a few seconds.To do imagery, make sure you are seated in a straight-backed chair with arms, your feet planted parallel to each other flat on the floor (this is called Pharoah’s Posture). Breathe out and in 3 times, out through the mouth and in through the nose, with the exhalation being longer than the inhalation.
Here are two exercises you can do at any time, but we think the first is especially good to do in the second trimester of your pregnancy and onwards, and the second in the last trimester close to the time the baby is born, or after the baby’s birth, as needed.
- SECOND TRIMESTER IMAGERY – Embracing the Mantle of Motherhood. Do this exercise first thing upon waking and last thing before sleeping for 21 days, or as needed once baby is born.
Breathe out and in 3 times and state your intention silently that you are now doing the Mantle of Motherhood transformation exercise to help you embrace and succeed in your new role as mother and it is taking a few seconds.
See yourself growing in confidence and power as your belly grows. Imagine yourself taking a breastfeeding class, enrolling those close to you, and becoming knowledgeable and excited about nurturing your baby and giving your baby the best start in life. See yourself nursing your baby and handling any obstacles calmly and competently; you are strong, yet flexible and can adapt, solve any problems, and succeed. See yourself surrounded by a loving community of women who have gone before you and who are cheering you on, see yourself being admired by the women who come after you who will learn to take on the mantle of motherhood from watching your transformation and learning from your experience. Breathe out one time. See, sense, feel and know that you are truly powerful and open your eyes - THIRD TRIMESTER IMAGERY – A Perfect Beginning. Do this exercise first thing upon waking and last thing before sleeping for 21 days—or if your baby is already born, do as needed.
Breathe out and in 3 times and state your intention silently that you are now doing the Perfect Beginning exercise and it is taking a few seconds.
See yourself after a wonderful birth experience. Your baby has just emerged from your body, wanting you and your love and nurturing. See your baby curled around your breast, melting into your body, warmed by your body temperature, comforted by your heartbeat and smell, and nursing blissfully away, getting all the nourishment (s)he needs from your Mom-Made Wonderfood™. You have no pain or discomfort. Breathe out one time and see your partner or a loved one, looking on at the two of you, thinking they have never seen anything more beautiful or perfect, and neither have you. Breathe out one time and see, sense, feel and know that you are powerful, able to nourish this baby and that this is the perfect beginning and open your eyes.
Talk About It With the Girls.
Just about every new mother gets to a point during that first week of motherhood when her hormones team up with her exhaustion and she feels completely overwhelmed and defeated. This is exactly when any unresolved issues or worries will creep into your awareness and try to get you to quit. This is normal postpartum stuff, Babes. It’s that wall again—the one that all mothers hit whether they are nursing or not! The key to getting past this tough time is to have someone you trust with whom you can share your tears, fears, frustrations, and enjoy a good laugh, so you don’t throw out the baby with the bathwater (i.e. make nursing the culprit when it usually is not). Too many moms have let their milk dry up at this juncture, only to later regret their decision and blame themselves, when they later learn that they could have gotten past the hump had they shared their situation with another woman and gotten help. An ideal friend can help you think straight enough to figure out if your nursing woes are emotional or physical—and if it’s the latter, remind you to call in an LC or help you find answers online. Please don’t try to tough it out alone. Women need to vent and get the compassion of others to overcome challenges. Don’t let this be the time you decide to deal with it on your own. Remember, 95% of nursing problems are easily corrected and avoided. So, this is the time to call in the women you trust and admire for sage advice and camaraderie (see our section “I Don’t Want to Breastfeed” for more).This is Not the Time to Be the Hostess with the Mostest.
As we said above, the learning curve period is a time for you to let the house go and whatever else goes with that. This is the time to let yourself be the center of everybody else’s attention. If you can accept and embrace your newly-earned status, and prepare and organize your postpartum life so that other people are busy with the rest of the chores, you will fare much better! You’ll be out and about running errands and shopping soon enough. Take these days to nestle in with your little babe and focus on bonding and breastfeeding, and you will both be better-tempered and more capable to take the show on the road in a few weeks. This is definitely not the time for you to be entertaining the relatives who want to meet your new babe. That goes double for your hospital stay — have as few visitors as possible in the hospital so that you can focus on learning your little babe’s hunger cues and latch and so you don’t have to deal with feeling uncomfortable nursing in front of others (although nursing can be done very discreetly, most moms find that the best learning position requires a full breast exposed – definitely not ideal if you have visitors!) The best gift a good friend or family member can give you at this time is supporting you to be able to nurture your baby: they can prepare a meal, do your laundry, the cleaning, the shopping, hold the baby while you sleep, play with older siblings, or buy you a visit with an LC who can provide more help than they can where breastfeeding is concerned. Here’s an idea for your baby shower—circulate a sign-up sheet with what you need so that meals and chores are covered. This is what women excel at—helping other women–so take advantage of it! Basically, anybody who walks through your door during this time ought to be willing to pitch in, not expect hors d’oeuvres and a perfectly polished home. Anybody who loves you will understand, believe us!Keep perspective.
As challenging as breastfeeding can be during the early weeks, you need to keep perspective about how short a time that really is compared to the lifetime benefits breastfeeding will give both you and your babe. Even if you are the type that wants to “get up and go” and hit that to-do list, commit to breastfeeding for at least 6 weeks. In the scheme of things, 6 weeks is not very long and will save you heartache over the things that tend to happen often with formula-fed babies; i.e. digestion difficulties, fussiness, painful constipation, intolerance to formula and formula switching, extra visits to the doctor for ear infections, more hospital visits (especially for dehydration from the stomach flu—something that affects breastfed babies far less), and so on. A favorite mantra of ours for new moms is “Everything is Temporary,”—meaning that as interminable as those first weeks seem, they aren’t. You won’t be nursing around the clock forever. Your baby and breastfeeding will continually change as (s)he grows and needs to eat less frequently – a six month old may only nurse 5-6 times a day, a one-year old may only nurse 2-3 times per day. Plus, more than likely, you will look back with fondness on that innocent and uncomplicated time of newness when it was just you and your baby cocooned in your own little world.The information in this document is in no way intended to diagnose or treat any medical condition and is not a substitute for an in-person evaluation by a breastfeeding-friendly pediatrician or qualified, independent Internationally Board Certified Lactation Consultant (IBCLC).
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