Thursday, December 23, 2010

A Quiet Lunch: Baby-feeding May Not Go Well at Parties

A friend was recently telling me about her new grandbaby, a plump but hungry little girl born by Caesarean section not long ago. The grandmother described how the young mother was worried about breastfeeding and fretting that the baby was not getting enough milk. She also told me of the scene at the new baby’s house when both grandmothers, friends, and various other visitors were all there, and the mother tried-- without much success-- to nurse the baby while socializing with the company.

Naturally, the difficulty she had with this nursing was disturbing to the mother. Like most mothers inexperienced with breastfeeding, she was afraid she wasn’t making enough milk and that the baby was starving. And the tenser she was, the more difficult it was for her to nurse the baby. Breastfeeding requires not only the “manufacture” of milk in the breasts, but a reflexive response to the baby’s sucking, the let-down or ejection reflex, that actually squirts milk out of the nipples. (This water-pistol effect is definitely part of the humorous side of breastfeeding!) Babies don’t just draw milk out of the breast as you’d suck lemonade through a straw, and if milk is not ejected, the baby will get only a few drops at a time rather than a mouthful. First-time mothers, especially, may find their milk does not “let down” easily when there is a lot of commotion or tension to deal with. Whether you’re particularly modest or not, you may find it awkward to nurse the baby when a lot is going on around you. From that point of view, it’s not surprising that my friend’s daughter-in-law had trouble breastfeeding while visitors were there.

But there’s another important point about this situation. The other half of the breastfeeding team, the baby, can also have trouble with exciting surroundings. This is so much the case that bottle-fed babies, too, may have trouble feeding when there are visitors-- and the bottle does not share the mother’s problems with letting down milk, of course.

Some years ago I was at a large party where a young mother had brought her toddler son and 6-week-old baby girl. The mother was longing to talk to all the people, many of them her cousins and friends she hadn’t seen for some time. She was trying to give the baby a bottle while she conversed, but guess what, the baby wasn’t having any; she would suck for a minute or so and then let go of the nipple, fretting. I guessed that everything was too exciting for this baby and offered to have a try. We went to a quiet room, sat down and snuggled and talked for a few minutes, then I offered the bottle and the baby slurped up every drop.

What was this all about? Did I have some kind of experienced-mother magic that I applied to this baby? No, but I was aware that even at the advanced age of six weeks, babies may have trouble organizing their feeding if there is something to distract them. In order to suck from breast or bottle, a baby needs to time properly her sucking, which brings milk into the mouth, and her swallowing. This seems simple to adults-- we even have the ability to swallow voluntarily, as in taking pills, or to take food into the mouth and hold it there without swallowing. But for the young baby sucking and swallowing are still primarily reflexive, and they have to occur at the right times and in the right order. Otherwise, the baby will choke on an excessive amount of milk, or the milk will run out of the sides of the mouth rather than going down.

So, what is the connection? Why should hearing people talk interfere with the baby’s coordination of sucking and swallowing? The problem is that a baby’s movements, breathing, sucking, and so on, are easily “entrained” to events in the environment. Entrainment means that the rhythm of actions begins to follow the rhythm of other things that are going on. It’s like adults dancing to music-- the movements of our feet follow the rhythms of the music. As adults, we can decide not to dance, or we can even dance to a different rhythm than the music that’s playing (though it’s hard to do that). Babies don’t seem to have any choice about entrainment. The rhythms of speech and movements around them can take over the rhythms of sucking and swallowing and make it difficult or impossible to do these things in the necessary pattern.

Young mothers may feel very out of things when they need to go away and be alone with the baby in order to nurse. But this may be exactly what’s needed for both parties. The mother may feel hassled and tense in a group of people, even though she wants to be there. The young baby is quite likely to be disorganized when talk, laughter, and movement take over her rhythms. A quiet place gives mother and child their best situation for feeding by breast or by bottle.

3 comments:

  1. I know I experienced this with nursing my children at gatherings, I spent most of my nursing time off in a corner or in another room. Not for modesty's sake but for the first few moths they seemed too distract able to get the job done. Sometimes I felt left out, but I had to remember that this was a very short span of time in each of our lives and that we both be back to being the life of the party in on time.

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  2. C-section babies can be a little sleepier in the very beginning too, I think. I remember us doing all sorts of things to get my boy to wake up and get feeding when he was newly born.

    Nursing isn't always just snap your fingers and mom and baby "just know" how to do it properly. These distractions you mention are great reasons to also consider when feedings aren't going perfectly. Also, when it's not being done properly, it can lead to other problems such as sore(er) breasts etc.

    I totally fretted my son was starving in the beginning so I can relate to that fear. Correct me if I'm wrong, the big concern about nursing in the early stages is dehydration more than starvation.

    I think more people would be likely to try to nurse longer if people were more honest about how it can be in the beginning. For some people it's a breeze, for others, it's not. Information like your post go a long way in helping new moms realize things aren't always like they appear on tv, or on some blogs.

    That although it's natural, it doesn't always come naturally!

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  3. I agree that dehydration is the big point at first.

    Anyway, it's certainly not always a breeze, and most first-time mothers have not even had a chance to watch closely when someone else nursed a baby, so they don't know what might be the breezier and less-breezy parts of the process. And it's so easy for women to blame themselves (and be blamed by others) if all does not instantly go as smoothly as they expect.

    I recently noticed that Arthur Janov, the Primal Scream guy, wrote about a patient who in his "primal" experience found that his mother's milk was sour, and this was the basis of his problems. This is a great way to blame the past for problems, but I don't really see how the milk of a living person could sour. It could be slightly salty if there was a breast infection, and can be flavored by garlic, beer,etc., just as a cow's milk can, but sour? I believe that's one of those problematic metaphors at work.

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