As a postpartum nurse on a more acute unit where women have had more difficult deliveries, immediately after the birth of their child breastfeeding is not necessarily on the forefront of their minds. Recovering, acceptance, adapting, and reevaluating the idealized version of their birth plan becomes intertwined with the reality that babies are born with their own agenda.
Time and again, my job involves reassuring new mothers of a few certain key points that may have escaped their attention as they poured over their baby books during their pregnancies. In theory, babies are born with an intrinsic motivation to root for and suckle at the breast. In reality, these miniature humans will do whatever they want to do until they too have recovered from their bumpy entrance into this world.
Here's what you may not have read in your baby books in regards to breastfeeding:
1. Not all babies are born with an instinct to latch onto the breast. Those who have had particularly precipitous deliveries and were basically rocketed out of the womb or those who were jammed in the womb in uncompromising positions for several long and gruelling hours before capable physicians were able to extricate them safely, may not necessarily want the breast. A good long nap on mom or dad's chest, referred to as skin-to-skin contact, may be adequate to soothe them. Sometimes these periods of refusing the breast can last for several hours to several days.
2. Quite often, babies will not have expelled the amniotic fluid ingested while in the womb. Due to varying circumstances, ie. c-sections, precipitous deliveries, or a long labour in which baby was "stuck" in the birth canal, this amniotic fluid is not squeezed out adequately in the birth canal. As a result, babies can be born "mucousy," which means they're stomach is full of amniotic fluid and old blood. Although this state is not harmful for babies, it does delay the breastfeeding process. Until the newborn expels the mucous via regurgitation or is helped along by staff via suctioning or a procedure called "lavage," these little critters will spend a considerable amount of time gagging on the breast. With a stomach full of gunk, newborns may attempt to latch, but often, will simply hang out at mom's breast enjoying her company.
3. Then there are those unfortunate lovelies who were pulled from the womb via forceps or vacuum. Although these procedures are necessary to ensure both mom and baby's safety, often baby will not respond well at the breast. Naturally baby's frantic crying at the breast is alarming to new parents who assumed that breastfeeding was an automatic response to being placed by the nipple. However, when a child has been pulled out by its head with a special device, finding a comfortable hold in which baby's head is not being manipulated in order to obtain the optimal latch is not as easy as it sounds. This experience is distressing not only for baby but for the parents, particularly mom, as baby consistently wails every time he/she is placed near the breast.
Although the above mentioned cases are not the norm in a healthy delivery, on the unit where I work, they are more common than not. My advice to all of my nervous and distraught mothers is this: contrary to what you may have read in your baby books, breastfeeding is not necessarily a natural conclusion to the birthing process. Babies do not all automatically know what to do.
Even though mothers are anxious to see their child latching well and feeding on the breast, to know that their particular experience is occurring in most every room on the ward, does help somewhat to dispel the belief that they have done something wrong, that there is something wrong with them, and/or that their baby will never breastfeed. Given time, patience, and tips from the nursing staff and the lactation support nurses, babies are usually supplemented with their mothers' colostrum via various methods until that precious newborn learns the ropes.
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