The topic for discussion this week was ‘Basic Breastfeeding Management’, which I imagined to be full of the core elements of the peer counsellor’s ‘tool-box’, I guess – and I suppose it was, but I was surprised at how much of this ground we have already covered. Nevertheless, we did, as always, have some interesting discussions along the way.

So we talked through a variety of factors important to establishing a confident breastfeeding relationship between mother and baby.
Many of us have experienced circumstances with our own babies that help us to understand how frustrating it can be for a new mum who feels things aren’t going well. It’s great that we can use that awareness to help new mums identify what the difficulty is and, most importantly, offer some solutions so that breastfeeding can continue.

We have been told how important early skin-to-skin contact is in establishing breastfeeding and our instructor said that she believes most mothers are given the opportunity of that experience now.
I was thinking about that myself recently, as the first two of my babies had a remarkably different start to the other three, even though they were all born at home.

My eldest was born after a ‘textbook labour’ – a big, healthy baby. I held him, skin-to-skin, for a couple of minutes, during which time it became apparent to the midwives that he was slipping away. He was then taken from me to be resuscitated – which took over half an hour – and then rushed to hospital in an ambulance. I didn’t see him again for an hour or two and didn’t hold him again for several hours. However, at 20 hours old, he decided a drip was not enough and began sucking his fists urgently. Breastfeeding began then and continued (in abundance!) for 8 months.

No.2′s birth was a little different. The two midwives in attendance were obviously uncomfortable with a home birth following our traumatic history. At the appearance of meconium in the amniotic fluid, they urged me to hurry up – completing the second stage in 10 minutes flat. They then took my baby’s temperature and dressed him before giving me the opportunity to hold him. Although I began breastfeeding as soon as possible, I was not as responsive to his cries and did not strive to keep him close to me all the time in those first few hours. He didn’t feed as much, he slept more and consequently he lost more weight and became more jaundiced than his siblings. As it happens, he has also experienced more health problems than his siblings too. However, we did establish breastfeeding well and we continued for 14 months.

It was interesting to hear that lack of the skin-to-skin experience at birth has been shown in research to lead to a greater weight loss and more jaundice – in common with my experience.

The positioning and attachment of the baby can also make a huge difference to the outcome of breastfeeding and we were asked to always consider checking attachment in our roles as peer counsellors, because it is such a common issue leading to difficulties.
As we talked about it, I was reminded of the huge difference in feeding a newborn to my current experience of feeding a toddler – and how easy it is to forget how awkward those first few feedings can feel.
We each talked about the most comfortable positions we had found and I was surprised by how many had used the ‘football hold’, as well as the traditional cradle-hold and lying down. The ‘football hold’ was not one that I remember using much myself, but other mums described how useful it was in feeding a struggling baby – and I could really understand the need for an alternative position. I do remember using swaddling in those circumstances, but there was often a hand popping out of the blanket and getting in the way.
I also found it hugely beneficial to use a sling – especially with my youngest, who always wanted to be carried or fed when I had to do something else.

As well as the different positions, we were reminded that the baby needs to be at the right height to suckle comfortably and most of us remembered using lots of pillows and cushions in the first few weeks. In fact, with my boy being so big now, I still sometimes settle down on the sofa with a pile of cushions, so we can be really comfortable.

We also discussed the importance of feeding on demand. I suppose this is one of the main aspects of breastfeeding which remains at the mercy of our cultural expectations. Lots of the mums in the group knew other mums who, despite adhering to all the other recommendations, felt it was important to feed by the clock. This had led to difficulties with some, but one mum in our group said her son naturally fell into a pattern of feeding ‘on time’ and she found that it didn’t interfere with continuing breastfeeding.

The importance of focusing on the baby’s cues is well-documented. In the early weeks, the mother’s body is responding to the baby’s body by producing more milk, the more the baby feeds. Restricting feeds at this time could lead to a reduction in the mother’s milk supply. Not only that, responding to baby’s cues is part of the dialogue between mother and child that goes beyond the breastfeeding relationship.
However, some babies do settle into a routine early on – and that just goes to show how different babies can be. My babies have differed enormously. My 4th baby rarely cried, sucked her thumb and slept through the night from 9 weeks. Of course we put it down to our fantastic parenting skills – and then we had no.5! He has been the opposite in all those respects!

It is because of those differences that we are encouraged to ‘watch the baby – not the clock’. Although we might want to guide them towards a routine that suits us and our families eventually, at first we must establish what their needs are and how we can meet them.

I feel very optimistic when I hear about this growing trend towards listening to our children, rather than controlling them. I know it isn’t as widespread as we would like it to be, but it is a positive step in a new direction.

Next week, we have a break for half term, so it’ll be two weeks before my next post, but please come back with lots of comments – it always makes for really interesting reading.

Juno