The 3 Big Misunderstandings around Early Days Breastfeeding (IMO!)

I wrote a blog a while back (http://latch.ie/breastfeeding-myths/) listing all of the breastfeeding myths that I have come across, and it’s now at 18. I’m not going to add to it, although I do still hear some nonsense about breastfeeding. What I would like to do in this blog is talk about the 3 big Misunderstandings about breastfeeding that I am hearing all the time these days. And for some reason more so lately. Here goes.

 

1.Babies Must be Fed Every 3 Hours. I’m guessing that what HCPs are saying to parents is that they should feed their babies AT LEAST every 3 hours, but in my experience, parents seem to be interpreting this message as ‘Feed baby every 3 hours’. This is leading some parents to schedule feeds, wake sleeping babies and experience high levels of anxiety. So what should parents be doing? Healthy, term babies who are gaining weight appropriately need to be fed often in the early days, at least 10 – 12 times per 24 hours. And on cue, ie whenever they show feeding cues. This is just how breastfeeding works. Watch the baby not the clock. Feeds will not necessarily be spaced out at regular intervals. Eg, you might have a 3 hour period in the evening where babies feed 6 times. And then a few feeds stretched out over a longer period. It can all be a bit random and chaotic. But most breastfed babies will not be interested in sticking to a 3 hour feeding schedule. However, with some babies eg late preterm or slow to gain babies, parents may need to wake them to feed and ensure that they don’t go for more than 3 hours between feeds. So when determining what a parent should do, ie wake baby to feed,be mindful of the clock, or cue-based feeding, so much depends on their individual circumstances.

2.Empty the First Breast before offering the Second. I think advice comes from the big fear out there around ensuring that babies get the ‘hind milk’. And I can see this fear in some of the mothers I see, who are almost terrified to switch their baby to the opposite breast before they have spent at least 20 minutes on the first. So what to do?! Again, as above, it depends. As a general rule, watch the baby not the clock. When they have stopped drinking of the first side, consider switching them to the other side – this enables them to get the letdown on that side. It’s an effective way to increase the volume of milk that baby takes at one feeding. And this approach is particularly useful for sleepy or slow to gain babies. It can also help to stimulate a mother’s milk supply. Sometimes my advice to a mother is to do lots of switching during a feed. However, sometimes I will advise feeding on just one side, eg if a mother has a very big milk supply. But in general, what I suggest in the early days is switching and not leaving baby on one side for a set time period (many mothers feel that they must keep baby on the first side for 20 minutes). If a baby is feeding on cue, he will get just the right amount of everything in his mother’s milk.

3.You MUST Wind babies after a Breastfeed. What I am seeing lately is a lot of this – baby feeding well at the breast, and then having a little snooze on his mum’s chest. But she feels she has to wake him to throw him over her shoulder and pat his back, or put him sitting upright and make circles with his torso. All to get his wind up. Because the message that she has imbibed somewhere along the way is that this is what you are supposed to do. But actually, many breastfeed babies don’t need to be put through this rigmarole. Simply lying on their tummies will exert a gentle pressure on their abdominal area which will help with digestion. Lying in this position also helps to tone the parasympathetic vagus nerve, which controls digestion. I’m not saying that no breastfeed babies will need help in bringing wind up, but that many don’t. I feel it’s important for us to encourage parents to do what they feel is appropriate for their baby. Because all babies are different.

The above blanket statements don’t serve parents well. I really feel that we need to explore other key messages to help support breastfeeding in the early days. Words matter and can have a big impact – positive or negative. High oxytocin levels help mothers become attuned to their babies, but also make them highly vulnerable to language. So we need to be sure that we are using the most appropriate language in order to¬† convey the right message.

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