Breastfeeding

WHAT’S BIRTH GOT TO DO WITH IT?

EVERYTHING THAT HAPPENS DURING LABOUR AFFECTS YOU, YOUR BABY, AND YOUR COLLECTIVE INSTINCTIVE ABILITIES

Can a decision you make even before baby arrives impact on how well they breastfeed? Remarkably, yes

ALTHOUGH A MOTHER’S motivation is an essential element to getting breastfeeding right, research indicates it is not the only one. Baby takes the lead in breastfeeding, and if he faces challenges, complications may arise. Everything that happens during labour affects you, your baby, and your collective instinctive abilities. Although sometimes what happens during labour is not in your control (for example an emergency caesarean section), you should always plan for the best. A breastfeeding-friendly birth prevents potential problems. But with help, even a less-than-perfect birth experience can result in a positive breastfeeding journey.

VAGINAL BIRTH

From a breastfeeding point of view, natural or vaginal birth (with minimal medical intervention) remains the ideal choice. A baby born naturally typically latches well, especially if mom holds him skin to skin for as long as possible. Although natural birth isn’t for everyone, most moms can achieve it with adequate support and information. However, a natural birth with aids/interventions can be more complicated for baby.

PAIN MEDICATION

If you need painkillers, don’t beat yourself up. Not all labours are created equal. If your baby’s position is unusual and your labour is long or induced, you may need it. Weigh up your options, discuss them with your caregiver, and choose the most breastfeeding-friendly medication. ENTONOX doesn’t impact breastfeeding. Your lungs expel the gas before it reaches your unborn baby. Entonox won’t eliminate the pain, but it will take the edge off and help you breathe deeply. PETHIDINE is a morphine-like painkiller administered via injection or drip. It’s usually combined with Atarax, a muscle relaxant, which doesn’t affect baby. Pethidine, however, is probably the least breastfeeding-friendly painkiller. It depresses baby’s central nervous system, making him sleepy. He’ll suck less frequently and less efficiently at this critical time (when you’re both mastering the art of breastfeeding and your body is establishing your milk supply). It has been found that 62.5 percent of babies whose moms received pethidine were too sedated to feed in the first two hours after birth. Another 17.5 percent sucked in a disorganised way, and only 20 percent nursed well. A newborn’s immature liver metabolises drugs slowly and consequently the effects of pethidine can last longer than a week. EPIDURALS may also complicate breastfeeding, although to a lesser extent. About 10 minutes after your epidural, the medication reaches your unborn baby. At birth, he may be less alert and slightly disorganised in his movements. These side effects often last for up to a month. Baby may not stimulate your breasts optimally; therefore low milk supply is more common after epidurals. Epidural anaesthesia is designed to numb your nerves and muscles so that you don’t feel pain. Unfortunately, baby’s nerves and muscles are also desensitised. He may have trouble locating the breast through smell, may not feel the nipple touching his lips, or have difficulty coordinating the muscles involved in latching.

INSTRUMENT BIRTH

Instrument birth can be detrimental to breastfeeding. It’s stressful for you, which interferes with your breastfeeding hormones. Furthermore it may disrupt the cranial bones, muscles, and nerves in baby’s skull due to the increased pressure. Around 60 muscles and six cranial nerves are involved in suckling. Even slight bruising may alter feeding patterns and create problems. Bruising increases the risk of jaundice, which makes baby lethargic and unlikely to feed well. Spend lots of time skin to skin. This lowers stress levels in both of you and triggers your baby’s feeding reflexes. Nurse in the position baby finds most comfortable. Some newborns battle to feed on one side due to neck pain. Try the football hold or laid-back breastfeeding position. If baby doesn’t latch within the first 90 minutes, express colostrum into a teaspoon to feed him. It’s a natural painkiller that stabilises baby’s glucose levels and gives him more energy to feed. If baby is unable to latch, ask your

paediatrician to prescribe a safe painkiller for baby. Consult a chiropractor too.

STRESS

Your first milk is called colostrum. It comes in tiny quantities, but is packed with nutrition and immune bodies. As a newborn’s tummy is the size of a marble, low-volume colostrum is all he needs until your milk comes in around day three or four. When your milk comes in, your milk cells absorb more water and your supply becomes plentiful. If you’re severely stressed during labour and birth, your full supply may come in later. This increases baby’s risk of supplemental bottles in hospital, which interferes with his sucking pattern, his gut flora, and your milk supply.

CAESAREAN BIRTH

Does a C-section impact negatively on breastfeeding? The jury is still out. Some studies suggest that C-sections cause delayed milk production; others find no link. Possible breastfeeding challenges after C-section are delayed skin-to-skin contact; separation between mom and baby; and babies who suck differently, are less alert, and are more likely to become hypoglycaemic (suffer from low blood sugar). Moms also have more pain and lower levels of the breastfeeding hormones (oxytocin and prolactin).

BREASTFEEDING AFTER A C-SECTION

Arrange to hold your baby skin to skin as soon as possible after birth. Keep him there until after the first successful feed, and as frequently thereafter as possible. Take your pain medication as directed after birth. Pain increases your stress levels, contributing to delayed milk supply. Baby drinks only tiny amounts of colostrum, so very little passes through to him. Ask for help with positioning. Try laid-back breastfeeding and/or the football hold.

INDUCTION

Induction is stressful for you and your baby. It’s more painful than normal labour. The contractions are stronger, your body secretes fewer endorphins, and you’re more likely to need drugs.