By Jen Jester, Birth Educator & Doula
In the dark, quiet of a hospital room I learned a valuable lesson at my most recent birth. On this occasion, my lesson was given by an amazing doctor whom I will refer to as Dr. X. I am entering into the “seasoned” portion of my doula career, and I have realized that I always have something to learn from each birth.
This particular learning experience actually had nothing to do with birth. This lesson was about breastfeeding and patience.
Allowing the mother, encouraging her, to stop “doing” and start trusting – That is one of many things that I do for my clients during their labor and birth. “Stop thinking. Allow your body to do its work,” I might say. But, I lost that mentality regarding breastfeeding somewhere along my path as a doula who works largely in a hospital setting.
Although I know the benefits/advantages/necessity of “Laid-back Breastfeeding”, it escaped my practice with mothers. I teach it in my birth classes, yet I have ceased to encourage the practice with my clients.
WHY? Well, in the hospital births that I’ve participated in – even the most “natural” births – the baby is usually placed on the mother’s abdomen for “immediate” breastfeeding. *And they mean it!* I learned early on that if I didn’t dig in and help that mother latch her baby on right away, a nurse in the room would assume my incompetence, roll her eyes, grab the baby and a breast, and set to teaching that kid how to latch on. She’d typically lay the baby horizontally across the mother in the “cradle” position, grab the mother’s breast, and force the baby to nurse by encouraging it to open its mouth, then shoving the mother’s breast in. This was contradictory to the education that I had and the reading I had done, but most of the time it worked and everyone was happy. The nurses are really good at and trained to get their tasks completed within a prescribed period of time for each patient in a very effective and methodical manner.
- Baby latched on? Check!
- Mom nursing immediately? Check!
- Countdown to postpartum floor admission? Check!
- Countdown to newborn procedures? Check!
So, I learned to jump in BEFORE the nurse, and get that baby latched on! My clients were paying me to help them breastfeed after all. I wouldn’t want them to think I’m falling down on the job, right? Well, I believe my actions actually did my clients a disservice. I knew in my heart I wasn’t doing the best for mom and baby, or that initial breastfeeding could have been a better, more natural experience, but I felt limited or trapped by the system around me. Imagine how my clients felt. Perhaps they didn’t think twice about the “help” the nurses or I were giving them. So it was. I was a cog. I would get to help the mother breastfeed before the nurses. Healthy attitude, right? Not. At. All.
BUT, what if breastfeeding doesn’t magically happen within our postpartum time frame of one hour? What about those babies who don’t like to be force fed? I have seen this play out, and it usually results in a crying baby, a crying mother, and feelings of inadequacy. Sometimes the baby is carted off to the nursery traumatized and hungry for newborn procedures.
At one point, I decided to only encourage “laid-back breastfeeding” with my clients that were new mothers; to help set the stage for their future breastfeeding experiences with subsequent children. They had no breastfeeding baggage. I quickly dropped that when at a homebirth the midwife poo-poohed my laid-back breastfeeding “idea”. She watched the baby working hard to get to the breast, and then jumped right in with the scenario I described above. I felt foolish. Was I losing my mind? Did no other birth professional know about laid-back breastfeeding? Was I wasting valuable bonding time? I wonder if the laid-back approach was just taking too long for these professionals’ comfort. I wonder if they truly thought the baby was struggling unnecessarily with its head bobbing as it made its way toward the breast. Perhaps it makes them uncomfortable.
With my clients that have nursed previously, I resigned to letting them choose their method of newborn nursing. They have wisdom, right? I didn’t consider that perhaps these mothers did not learn laid-back breastfeeding, or that it had been so long since they had a newborn to the breast that they may not recall the best way to handle this tiny new baby. I saw most of these moms holding their newborn like a 6 month old veteran nurser.
So it was for my most recent birth. I was aiding this mother in the delivery of her third child, a daughter, in a quiet hospital room. The doctor quietly encouraged this mother to follow her body’s instincts for labor and birth. There was no rush. No bright lights. No noise. An already unfamiliar scene at the hospital, but it felt right. The room was filled with love and encouragement for this mother. She was surrounded by a team of 4; the father (feeling comfortable enough for the first time to watch his wife deliver their baby!), her nurse (following the doctor’s cues to be respectful, quiet and hands off), me (at the mother’s head giving hushed encouragement and physical support), and Dr. X.
What was Dr. X doing? Nothing.
Well, she was really doing something by “doing” nothing. She was observing; keeping a watchful eye. She knew this woman would deliver her baby just as she needed to. She trusted the baby would find the right position, like a key in a lock, as she descended down her mother’s canal. Patience. Dr. X applied a warm compress and a soft voice when needed. Not my typical delivery experience.
You may know what I’m referring to: Although I try to encourage the staff to follow my clients’ wishes, the nurse continually checks the mother’s cervix as the mom continues to feel “pushy”. Doctors, nurses, residents flood the room with lights, noises, loud talking, wheeling in equipment, and everyone in the room is instructing the woman just how and when to push while they watch the monitor. Alas, routine care pervades. Patient wishes, and an ancient wisdom are dismissed. Pressure. Direction. Passive process.
Not this time!
Back to our unusual scene:
The baby girl is born over an intact perineum and placed on her mother. Baby is assessed and nursing can commence! Since this mother has 2 other children, I wait and see how she does on her own with breastfeeding. She struggles with the baby as she cradles her and manipulates her breast into her mouth without any cues from the child. The baby cries. I quickly glance at the nurse, and then jump in to the “rescue”. I ask, “Would you like some help?” “Yes!” the mother replies. I help calm the baby and massage the mother’s breast to encourage colostrum to the nipple. I tickle the baby’s face with the nipple several times and wait for a nice gape. I roll the mother’s breast into the baby’s mouth. Baby lets go. We repeat. Baby lets go. Repeat, again. With the breast in her mouth, baby closes her eyes and stays still, uninterested. Mom is frustrated. Dr. X – patiently watching this whole scene – gently says something like, “You know, there is something called the breast crawl that I’ve seen where the baby is placed on the mother’s chest, and finds its way to the breast, and attaches itself when it’s ready. Want to try that?”
Of course! She’s right. I snap out of it and everything I know spills into my conscious mind. I step back. No pulling, pushing or manipulating of body parts. We adjust the baby vertically between the mother’s breasts. I watch the ancient magic happen. I “do” nothing. The little one acts on instinct kicking her legs, crawling, smelling, reaching, bobbing. All is done without instruction – without “help”.
The mother looks at me and asks, “Can I help her?” “Sure”, I say, and I show her how to guide (not force) her to the breast. Success! The baby latches on, and actively suckles. The mother releases a big sigh and melts into the bed. She lovingly beholds her daughter.
I am surprised at the tension in my body at this time. My shoulders. My breath. I had been poised and ready for action that was not helpful or necessary. Dr. X sat and watched with a knowing look. She reminded me that I should still help mothers nurse in a laid-back style no matter if it’s their first baby or their sixth. She also reminded me that birth and breastfeeding in the hospital (with proper leadership and respect) can be mother-led and beautiful. I am thankful to her for jolting me out of my hospital routine. We need more doctors like Dr. X. And, I need to be a doula that remembers that “doing” or helping with breastfeeding as well as birth, is sometimes doing nothing.
Lesson: On most occasions, letting the baby exhibit its ancient wisdom is exactly what the doctor ordered.
Guidelines for laid-back breastfeeding: Download pdf here, from the Womanly Art of Breastfeeding
Laid- back breastfeeding, or Biological Nurturing, means getting
comfortable with your baby and encouraging your own and your baby’s
natural breastfeeding instincts. See biologicalnurturing.com for further
- Dress yourself and your baby as you choose.
- Find a bed or couch where you can lean back and be well supported— not ?at, but comfortably leaning back so that when you put your baby on your chest, gravity will keep him in position with his body molded to yours.
- Have your head and shoulders well supported. Let your baby’s whole front touch your whole front.
- Since you’re leaning back, you don’t have a lap, so your baby can rest on you in any position you like. Just make sure her whole front is against you.
- Let your baby’s cheek rest somewhere near your bare breast.
- Help her as much as you like; help her do what she’s trying to do. You’re a team.
- Hold your breast or not, as you like
- Relax and enjoy each other.
Laid-back nursing Video here: http://www.biologicalnurturing.com/video/bn3clip.html
Breast crawl video Here: