I am, and have been, a strong advocate for natural birth. I believe women should be able to give birth where they feel most comfortable and with whom they feel most comfortable. Care providers of all stripes should be offering evidence-based care that respects pregnancy as a normal part of life, rather than seeing it as an illness that needs to be cured or a tragedy waiting to happen. In the Twin Cities area, we’re lucky to have a wide variety of safe, supportive birth options for parents. (You can get a glimpse of just how special we are here if you watch Midwife, a documentary by Allison Kuznia. Look for, or host, a screening near you.)
One of the things that birth doulas and midwives (at least, the kind of midwives who dig normal, physiologic birth) like to talk about is trusting the process and trusting your body when it comes to birth. Our bodies have spent a millions of years figuring out this complicated dance that we don’t even fully understand. And while, sometimes, interventions are needed, that is a rarity rather than the norm, and many minor interventions can be used before major ones come into play.
But it seems that once a baby is born and the placenta detaches, this mindset drops by the wayside. The message seems to be, “Trust the process of birth, but breastfeeding isn’t to be trusted.” Parents, too, can be guilty of having this mindset. Maybe this is, in part, because so much time is spent planning for birth that thinking and learning about the postpartum period does not receive as much attention as it deserves.
Within the many, sometimes intersecting, parenting- and professional-related circles I’m in, breastfeeding questions are asked with some frequency. There are concerns about milk supply (low and high), overactive letdown, food sensitivities, thrush, a baby’s gas, poop color, and so many other things. In almost every case—aside from advice given by women who are skilled and seasoned in lactation support—there is a call for some sort of intervention. (Please note that I list the following suggestions as examples of what I hear, and not solutions to these concerns.)
- For low milk supply, galatogogues are often suggested: eat lots of oatmeal, take some fenugreek, have you tried Mother’s Milk tea? Drink tons of water! And pump a lot in addition to nursing!
- For high milk supply and overactive letdown, block feeding is the preferred intervention.
- If a baby is fussy or gassy or has poop that is different than expected, food sensitivities are pointed at as a culprit. Cut out dairy/gluten/soy from your diet.
- Did you have antibiotics during labor? You probably have thrush and that’s why your nipples hurt. Take some probiotics and give them to your baby.
All of these things might be valid interventions if the complaint is a true problem; there is a very wide range of what is “normal,” and even birth professionals may not be aware of this range. It must also be a problem that warrants intervention; “tincture of time” is a phenomenal treatment for so many things. Even then, you have to look at the big picture. If a baby is gaining well and having enough wet/dirty diapers, there isn’t a low supply problem. A latch that isn’t at its best is the biggest cause of sore nipples, and thrush is probably not the culprit in those cases where an infection is to blame. And so on. Much of this is too much to assess from a few sentences asking for help on a mailing list, and many of the details a lactation professional would use to troubleshoot a nursing dyad’s problems may not be significant to anyone else and, thus, they wouldn’t bother to ask.
When it comes to interventions during birth, a doula might suggest providing counterpressure to alleviate pain during back labor. This is a pretty minor intervention; I would compare that to helping a mom work on laid-back breastfeeding to encourage a gentle latch from her baby. On the other hand, I would put suggestions of using fenugreek or other galactogogues on par with a mom receiving Pitocin to increase her contractions during labor. This is an intervention that is occasionally warranted, but most doulas and midwives would actively seek to avoid that situation. Just because an intervention is “natural” doesn’t mean it is necessary—or harmless, for that matter.
I’m not sure why there is a lack of trust in breastfeeding. Maybe it is because so many women have had difficulties when breastfeeding their own babies (and for this, my heart goes out to you; I know how hard it can be), and that carries over into how they support breastfeeding mothers later. (This happens when it comes to supporting birth, too.) Maybe it is because new parents, even seasoned new parents, can be hypervigiliant, with their intuition on high alert and a great fear of messing up that leads them to take the most cautious approach possible, even if it may not be the best approach for the long run. I suspect, too, that there is a strong desire to do something, and “doing something” in our modern American culture often involves intervening when it’s not entirely necessary.
Whatever it is, I encourage that parents and care providers alike step back, take a breath, and try to examine the whole picture before jumping to conclusions. Don’t assume that whatever is happening is abnormal, and if you don’t feel qualified to answer questions, refer to someone who does. Trust that breastfeeding works; it has worked for the same millions of years that birth has. When true breastfeeding problems crop up, there are lactation professionals available to help you work through them, and, even then, the solutions may be simpler than you may think.
I admit that part of my concern is in looking at the big picture. What happens to breastfeeding when we assume that it doesn’t work? What happens when we intervene too often in a normal process and undermine a mother’s confidence in her ability to feed and nurture her child? What happens to us, as a society, when most of our mothers receive this treatment? How can we expect to normalize breastfeeding and see more babies breastfed longer if lactation is treated as a tragedy that’s waiting to happen?
