The Hidden Reason Many People Stop Nursing Their Babies
It’s often said that body feeding (breastfeeding or chest feeding) your baby is “natural”. If you've nursed a baby or supported anyone who has, you know while that may be true, it's not always straightforward. Learning to body feed your baby takes patience, a lot of practice, and accurate information on what to expect at different stages of the experience. It also requires knowledgeable support from a trained lactation professional, and it's here where many parents are let down.
Many of us aren't taught to use a team model for our new baby's care, where we reach out to the appropriate professional based on our child's needs. Most new parents don't know that while their pediatrician is the expert for supporting their baby's physical health and wellness, they're not experts (or even trained) in many areas, including lactation.
Yes, you read that right. Many pediatricians do not have basic lactation training. Though your pediatrician may know about the evidence that demonstrates human milk is the best option for a baby, their recommendations may not support a successful body feeding relationship.
Why can’t my pediatrician offer lactation advice?
We've seen well-meaning pediatricians torpedo a parent's ability to meet their body feeding goals in several ways. Many times, these misunderstandings are related to a baby's weight gain.
Understanding Birth Weight Loss
Almost all babies will lose weight after they're born, this is a normal expectation. Babies are typically weighed within a few hours after birth and that information is logged. In the days following birth, their weight is compared to their birth weight to see how much they have lost. Based on years of research, the recommendation is that anything less than a 10% weight loss is considered normal.
What's important to know is there are interventions that may be used during labor and birth which can increase the appearance of an infant’s weight loss. Should IV fluids be medically necessary, like when used with pitocin, antibiotics, epidurals, and cesareans, they may cause an artificially high initial birth weight for babies. This inflated birth weight is related to the retained fluids both you and your baby can experience when using an IV. This temporary increase in weight is not always considered when weighing a baby in the days after birth which can cause caregivers to perceive weight loss after birth to appear higher than it is.
Your pediatrician's primary goal is to ensure your baby is gaining weight, which is a good thing! However, not looking at the full picture of why an infant may have lost weight can lead to a recommendation to supplement feedings before a parent's milk has even come in. Should this be the case, how can we make sure babies aren’t missing out on all that amazing colostrum between pumping and bottle feeding? A lactation professional would recommend ways to support your milk supply and feeding methods which can help you and your baby still learn to body feed. Unfortunately, many pediatricians don’t know about these options. Not surprisingly, we often see early supplementation leading to greater difficulty down the line if it hasn’t been supported by both your pediatrician and a lactation professional. But that doesn’t have to be the case. These things are at the forefront of our minds as lactation professionals.
Tracking Your Baby’s Weight
The next issue we commonly see is a body fed baby not being compared to the appropriate growth chart. If parents are body feeding, it’s important to confirm their baby is being compared to the World Health Organization infant growth chart. While other growth charts are made up of mostly formula-fed babies, the WHO growth chart is predominantly babies being fed human milk. This is an important distinction because body fed babies compared to the wrong growth chart can appear to have weight gain issues when in reality they’re gaining just fine.
It’s Not Your Supply
It's very rare for parents to have a low supply for no diagnosable reason. Often, small and simple changes make a big difference in the way a parent is feeding their baby, and an appropriate supply will then follow suit. Many parents are given the advice to feed on a schedule; however, this goes against what most lactation professionals would consider best practice and can impact supply. Rather, a lactation professional will suggest babies be fed based on their hunger cues. And as always, there's usually work we can do to create a more efficient latch so that milk transfer improves.
Well-meaning Solutions
Like we said, your pediatrician’s main focus is helping you get your baby’s weight up. This advice and a clinical eye are needed to ensure our baby is developing appropriately. One of your baby’s main needs in the first few months is to grow, which they'll do a lot of! Babies experience four growth spurts in the first six weeks of their lives.
When a parent has the goal to continue body feeding, we'll often see pediatricians prescribe a lactation plan. Though well-intentioned, this plan lacks professional lactation knowledge, isn’t based on up-to-date evidence in supporting lactation, and often ends up being an overwhelming and unsustainable solution.
We see it time and again. Parents are advised to feed their baby for a prescribed amount of time, which goes against lactation advice to feed to your baby’s cues they are full. After that 15 to 20 minute feeding, parents are now advised to express milk with a breast pump. This in itself can be damaging to parents, who often don’t know their pump is less effective at expressing milk compared to their baby. On top of that, many parents have unrealistic expectations of how much milk they should be pumping, and now assume they’re seeing the proof they’re supply is too low. Parents are often advised to feed the pumped milk to their baby using a bottle, which can require a very different set of skills and in turn, interrupt both parent and baby learning how to latch properly.
Once the feeding and pumping routine is done, parents need to clean their pump pieces, collect themselves, and prepare to do this hour or longer routine again soon after. This is completely unsustainable for many parents, and we absolutely understand why many parents decide to leave body feeding behind.
Parents are left feeling like they failed, that it was their body that didn’t have what it needed, and processing the loss of a feeding relationship they hoped for.
How Do We Help Parents Keep Body Feeding
The answer is so simple: Appropriate professional support. As parents, we don’t expect our pediatrician to have the answers for detailed issues with our baby’s ears, nose, or throat, which is why they’ll recommend you see an ENT doctor. If more pediatricians referred parents to a lactation professional right away, we’d likely see more parents successfully meeting their body feeding goals.
The issue with focusing only on increasing your baby’s weight is that it doesn’t get at the root of why feeding isn’t going as well as it could. A lactation professional can help you improve your latch, get on a better feeding schedule, have clearer expectations about what to expect with feeding patterns as your baby grows, and even help you have a healthier relationship with your pump.
When lactation support happens early and is recommended by a care provider, we see healthier babies and nursing success. We know the immense benefits human milk provides children, so the goal should be to ensure parents are properly supported by a lactation professional. It's also vital for the mental and emotional health of feeding parents. We need a world where fewer parents think their body isn't capable of supporting their child and instead recognize some patience, practice, and lactation support can make all the difference.
