The Breastfeeding Relationship: How Moms’ and Babies’ Innate Responses Connect for Ideal Nursing “Technique”
by Laura Keegan
As a practitioner, family member and friend, I have learned the most about what makes breastfeeding work, from watching mothers feed their babies. When moms are simply encouraged to get comfortable in any position that keeps their arms and shoulders relaxed, it allows them to hold their babies close, skin-to-skin. As a breastfeeding mom, learning to breastfeed was so much easier with my third and fourth children. I understood and followed my own babies’ innate movements to feed and I learned that, unlike a bottle-feeding baby, a breastfeeding baby’s mouth should not be centered over the nipple. I experienced the calming effect of keeping their bottoms close to my body as their heads moved in search of the breast, and the importance of giving them support with my hand at their shoulders so their heads could move freely when searching for and taking the breast. This understanding helped me whether I was feeding my baby while sitting up or lying down.
This closeness and comfort often naturally unfold at birth when moms and babies find their own way and babies feed for the first time. Whether moms birth standing, sitting or lying down; immediately afterward, moms tend to get themselves into a restful position in bed and hold their babies against them. The mother’s body supports the baby’s weight, and she elevates her head and back enough so she can easily see her baby on her chest or belly. Her arms and hands are free to follow and support her baby. Most of the time, if the baby is put on the mother’s chest (skin-to-skin, not wrapped like a burrito) within the first hour, the baby will instinctively begin “rooting” and searching for the mother’s breast.
The baby will be calmed as the mother follows and gently supports his natural movements in search of the breast, keeping him close to her and talking to him. The mother’s natural act of cradling her baby’s bottom and keeping it against her body makes him feel secure. Supporting him with her hand at his shoulders gives his head enough room to move freely and take a deep mouthful of breast with ease. This early instinctive nursing sets the stage for an easier “learning curve” and more comfortable breastfeeding experience. (When mom keeps baby close, it is important that she not place her hand on the back of her baby’s head. If she does, she will see that he may turn to her thumb or fingers or push back on her hand, and her hand can confine his head movement not allowing him room to extend his neck so he can get the deepest mouthful of breast possible.)
Whether a baby is born vaginally or by Cesarean, skin-to-skin contact can begin at birth unless there is a medical reason that prevents it. Although this is not yet common practice in the typical American hospital, a newborn can be placed on mom’s chest at birth in the operating room during the operation. The World Health Organization recommends this practice and moms and babies given this uninterrupted contact at birth find it peaceful, reassuring, and calming.
If for some reason the mother can’t hold the baby, the father can hold the baby skin-to-skin, both for bonding and soothing as well as for warmth. Even if the baby must be separated from the parents at birth, skin-to-skin contact at any time is beneficial to breastfeeding and mothers can initiate a comfortable, joyful breastfeeding relationship once they can be together. The skin is the largest sense organ and, as such, skin contact allows mom and baby to fully tune into each other and the feelings of closeness; calming them both, allowing them to get comfortable and relaxed as they respond to each other and breastfeed.
When mom and baby have not experienced the joy of a satisfying feed at the breast, it can be frustrating and tense for both, and telling mom to “relax” will only create more tension. A frustrated mom often reads everything the baby does near the breast as rejection. It is important to remember that the baby wants to breastfeed and has reflexes that are nature’s design to help him find the breast and feed. A calm baby, ready to feed has full use of his reflexes that make feeding easier. These reflexes are less readily apparent when a baby is upset and crying.
While being held, babies’ early signs of hunger include a lot of head movement, sometimes gently falling toward the breast but often bobbing their heads up and down, or throwing their heads to the side, often away from the person holding them whether it is the mother or someone else. Often a mother will interpret this characteristic head movement as a turning away or rejection of the breast when it is actually a searching for the breast. When the baby’s head movement makes his face momentarily lose contact with mom, he often cries because he searches for the breast by touch not by sight. Mom’s voice and her gentle guiding hand that keeps his face touching her lightly will reassure him.
It is important for moms to know that a baby’s natural reflexes to search and take the breast to feed do not disappear if the baby has not been feeding at the breast for whatever reason, even if those feeds came from bottles. It is important that moms know this fact, so they do not feel breastfeeding is doomed to failure, if their babies have been bottle-feeding. Avoiding bottles and artificial nipples, while establishing breastfeeding is helpful, but creating fear around bottles or other “rules” is not helpful.
When there are breastfeeding problems, I often tell mom to spend a weekend in bed with her baby with lots of skin-to-skin contact. Often the baby will root and search for the breast with this easy access when he is hungry. Mom can talk to him and gently keep him close as he searches for the breast. He may or may not take the breast the first time but will have multiple opportunities to breastfeed. Also, moms and babies are spending time skin-to-skin without always having the stress of an impending feed with uncertainty and tense expectations.
It is always good advice for moms to spend time skin-to-skin with their babies, even if breastfeeding is going well, because it promotes milk production, is restful and relaxing and keeps moms and babies together at a time when they both need to be close. The calming effects allow mom and baby to tune into their instincts which help the flow of the breastfeeding relationship and ease the transition that birth brings. The impact of skin-to-skin contact cannot be emphasized enough for its many benefits for mom and baby. Moms and babies need the opportunity for this life giving and sustaining act.
View this video of a premature baby born at 27 weeks who is brought back to life when placed on mom's chest skin to skin and took breastmilk from her finger:
Laura Keegan is the author of Breastfeeding with Comfort and Joy, a speaker, and a Family Nurse Practitioner (FNP). She has been in clinical practice for over 25 years. She maintains a holistic solo private family practice in Dutchess County, NY, one hour north of NYC. She is married and has four children.