Milk Supply and Newborns—in Perfect Harmony

Lately, I have been trying to re-frame the way I think and talk about the first hours and days of breastfeeding a newborn. I came to the conclusion that if I truly believe that everything works in perfect harmony in nature, I needed to appreciate and understand the dyad’s relationship at birth prior to any attempt to "fix" the breastfeeding relationship. Once I removed any preconceived ideas and expectations and learned to appreciate the birth and postpartum period, I discovered that all mysteries dissolved. I believe (and research supports) the fact that the dyad thrives and survives through skin-to-skin contact. Since this is the optimal condition following delivery, the baby can begin to trigger the milk-producing hormone, prolactin; and milk-ejection hormone, oxytocin, just by “being in the right place at the right time.”

If the baby is separated from the mother, the mother’s body is somewhat confused and may even go through a "mourning" period. The stage was set to feed an infant when the placenta was delivered and the progesterone levels plummeted, but without the presence of a recipient, the mother’s body is not sure if milk is necessary or exactly how much is required. Without stimulation, the prolactin receptors are not laid down and milk production is in limbo.

In order for production to commence and maintenance to occur, baby must be allowed to set the pace. The infant is born with the life-saving skill of sucking. Without this inborn reflex, the baby would not survive. People have misinterpreted this reflex for generations. Some have diagnosed that the baby must still be hungry since the suck reflex is still present following a feeding session. This is no more correct than saying that a child must need a nap because he keeps blinking.

 The newborn’s suck is exactly paced and the mother’s milk compliments the demand. Since the newborn has a strong desire to suck, he may engage in this ritual with few breaks. Respecting this inborn reflex results in an appreciation for the infant's feeding pattern and mom's supply.

 Colostrum is very thick and is coaxed from the breast slowly; precisely the reason constant sucking is needed to extract the liquid gold. It is also crucial to the baby’s small stomach capacity that the fuel he is collecting is deposited in very small amounts. The consequences of a fast-flowing liquid filling the stomach with a few sucks would be catastrophic. A newborn would not be able to manage the volume if milk was plentiful immediately after delivery. Lactation experts and health professionals have used terms like "milk coming in" for years, when in reality, milk has the right consistency, right antibodies, right amount, right temperature, right availability on the right time table.

While the baby was in utero, he was fed on demand and was never left wanting. Now experiencing the extra-uterine life, he expects his needs to continue to be met. During labor and delivery, the baby had the advantage of the umbilical cord and a direct line to nutrition. Babies are not born famished--quite the contrary.  Babies are not always eager to eat immediately after delivery.  Often babies take one to two hours to find the breast and commence sucking.

Since babies have been regularly fed in the womb, they only need small amounts of colostrum to keep the gut lining coated to protect from disease and infection and some nourishment for caloric intake and to expel the excess red blood cells and prevent or treat jaundice. Drops of milk meet these needs. Constant sucking causes the "order to be placed" for more milk in the future. Constant sucking soothes and comforts the newborn. Constant sucking results in the right portions of nutrients to enter the digestive tract. Constant sucking makes the uterus contract and control postpartum bleeding in the postpartum woman. What a perfect relationship. Mom and Baby learning together…baby learning to suck, mom learning to respond. There is perfect harmony when we see the couple as one unit and allow nature to take its course.

In order to demonstrate this concept and provide a convenient tool for lactation educators, I invented Lactation Lanyards.  These teaching tools allow educators and nurses to provide on-the-go education.  I was familiar with the concept that newborns have a stomach capacity of approximately 5-7 ml at birth, the equivalent of a teaspoon, but to convey this message to new moms was challenging.  Now moms have an accurate visual to reinforce the message.  New moms often question their ability to produce enough milk, and seeing a two ounce bottle in an isolette increases their anxiety.  When moms are confronted with the Tiny Tummy Teaching Tool, they are immediately put at ease. The lanyards are equipped with a safety clasp and colorful bead depicting the infant's stomach capacity.  The Colostrum Card provides quick, accurate information about colostrum and its importance.  These tools are being used regularly in hospitals, WIC clinics and other perinatal programs.  They are available at www.birthingandbreastfeeding.com.