Thursday, February 12, 2015

The Slippery Slope of Supplementing

There are a few pieces of education that can prevent unnecessary supplementation of formula or unintentional weaning. One problem is that many people misinterpret baby behavior. A baby communicates various ways. He uses body language, head movements, hand gestures and crying as forms of expression. The crying stage is usually what brings on the bottle.  A baby's cry brings full attention to the situation. The cry is annoying, upsetting and a "call to action." It was designed that way. If a baby just whispered, "Hello, up there, I'm over here and I need you." More often than not, the busy, distracted people around would not be aroused to take action. Since the cry demands a response, parents begin the ritual of calming baby. If the baby does not settle right away, parents will often resort to a bottle assuming that their baby is hungry. The bottle will elicit the suck reflex, making it difficult to cry. The baby also soothes by sucking so he continues to suck for comfort which reassures the parents that baby was indeed hungry. This sucking reflex is just that--a reflex. When we go to the doctor and he checks our patellar reflex with a hammer, if our leg spontaneously jerks forward, the doctor does not exclaim, "She wants to play soccer, see, just confirmed it!" That would be ridiculous, yet we use this reasoning when deciding that a baby needed supplements.

Everyone must also learn to appreciate and respect the fact that a woman's body and baby communicate through a series of events. Baby does at times need more milk and he must communicate this. The infant will "place his order" by frequently visiting the breast. He even tells his mother's body that he is not satisfied. He fusses, grunts, pulls his head back and arches his back. This arrangement convinces the mom's body to step up production. Many professionals used to refer to these stages as "growth spurts," until it was shown that growth does not necessarily coincide with the frequent breastfeeding. More recently, the feeding frenzies are being called, "frequency days." However they are labeled, they do occur and are necessary for regulating milk supply.

The body is amazing. It does not have to store all the milk the baby needs per day or week. It creates milk made to order. If a baby needs more, he expresses his desire and the breast-feeder complies.  Herein lies the problem. If a baby is given a bottle during these moments of frustration, it communicates with the woman's body, "Never mind, seems like baby is satisfied, it was a false alarm." The mom's body has no reason to produce more. The next time baby models the same behavior, parents may respond with the same solution. The baby will often take more from the bottle and if the supplement is formula, the ingredients are more difficult to digest and this "heavy" meal may encourage baby to sleep longer. A longer nap will also communicate to Mom's body that baby doesn't eat as frequently and she doesn't need to make milk as often. Next. the mom will notice a definite decline in milk, convincing her to supplement even more. Unfortunately, this unintentional weaning happens too often. Disappointed moms feel as though they were broken and could not effectively breastfeed. They think they were starving their newborn because he appeared unsatisfied with her milk, not knowing that this protesting was the exact recipe for increasing milk supply. If moms were encouraged to trust their amazing bodies and constantly put baby to breast so he could effectively communicate his needs and that the body would respond to meet those needs, we would see women empowered rather than defeated.

The good news is that the woman's body still wants to feed and meet the needs of her baby. The situation can be reversed. Mom must put baby to breast every time baby will nuzzle, suck, cuddle or nurse from the breast. It is also a good idea to practice skin-to-skin and get oxytocin freely flowing. Without this contact, the mother's body is persuaded that the baby is getting fed elsewhere and it needs to shut down production.

If breastfeeding has stopped completely, contact an IBCLC to help with re-lactation. Lactation Consultants can also help the mother who needs to supplement by sharing ways to continue the breastfeeding relationship and instruct on how much supplementation is necessary.

Interested in becoming a Certified Lactation Educator (CLE) and sharing evidence-based education with others? Sign up for an upcoming training on the Birthing, Bonding and Breastfeeding website.


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