As a lactation consultant, I have been lucky enough to work with breastfeeding mothers from the day their babies are born to the day their babies wean. New mothers encounter many concerns with breastfeeding, especially if it is their first child. The most common concern for many mothers stems from this statement, “Everyone tells me something different about breastfeeding!” I can understand their frustration.
Someone once asked me, “If you could get all healthcare practitioners to know one thing about breastfeeding, what would it be?” The answer quickly came to mind: Stop giving new parents the RULES of breastfeeding, specifically, how long a baby needs to nurse! Mothers receive suggestions to nurse for a certain amount of time, or to nurse on a particular number of breasts, or to limit the time at the breast.
Dr. Nils Bergman, a physician who has done research regarding skin to skin contact, or Kangaroo Mothercare, with premature babies and full-term babies, has also studied normal mammalian behavior. If you truly look at us as mammals, the whole idea of timing a baby at the breast is absurd! Picture a mother cat, looking up at the clock, removing her new kittens from her teats, rolling over and offering them the other side. Are you giggling as you picture this? What Dr. Bergman’s research shows us is that the newborn baby is in charge of the feeding, not the mother. The newborn is the one who initiates the feeding time and the length. I know what you’re thinking…but we’re smarter than other mammals. Are we?
We have the benefit of research to help us learn new things and in recent years the breastfeeding research has increased immensely. There was one research article that stated a baby gets most of their feeding in 20 minutes. Therefore, a large amount of healthcare professionals decided to tell mothers to nurse for 10 minutes on each breast and that babies don’t get anything after 20 minutes. In my experience, this statement typically preempts, “And be sure your baby doesn’t use you as a pacifier.” Well if we read the study carefully, the word MOST is what pops out at me. Do babies thrive by taking most of their feeding or all of their feeding? We know that the body’s ability to make milk is a result of the amount of milk taken out. So, if babies only take a portion of their meal, they will not gain weight and mom’s supply will gradually decrease.
Another study shows us that the fat content in the milk increases the longer the baby is at the breast. This fattier milk is called the hindmilk. So now I hear healthcare professionals telling mothers to nurse on one side per feeding to be sure the baby gets the hindmilk. Are there babies who require two breasts per feed? Absolutely! Do they come with a sign? Absolutely not!
For years we have known that sore nipples are caused by poor latch and positioning. If a mom is experiencing pain, the first line of defense is helping her to achieve a better latch with her baby. Yet, I continue to hear healthcare professionals telling mothers that they may have been feeding the baby for too long…so moms start watching the clock.
While working with mothers, these are the questions and statements I frequently come across:
- My baby won’t feed for 20 minutes; do you think they’re getting enough?
- My baby wants to nurse longer than 20 minutes, is there something wrong?
- How long does it take for the baby to get the hindmilk?
- I’m feeding my baby on one breast, but he acts like he’s still hungry. Isn’t he getting enough hindmilk?
- I was told not to let my baby to use me as a pacifier. How do I know when he’s finished?
- I was told that leaving the baby on for too long will give me sore nipples.
Breastfeeding is like a dance, and it takes two to tango! Mom and baby are a breastfeeding couple, but each works individually.
First we’ll take a look at mom: Dr. Donna Ramsay from Australia has done some fabulous ultrasound work of the breast. Basically, what we now know is that every mother has a variable number of lobes and ducts within her breast (the parts that make, hold and carry the milk). Each mother’s breasts are different which result in a varied ability to store milk. We’ve also learned that mothers’ milk does not flow at an equal rate. Bottom line, each mother is different.
Now we need to look at the baby: Some are voracious eaters, nursing very quickly and others are a bit more relaxed during their feedings. This is why some mothers say that their baby nurses in 10 minutes and others will say that their baby nurses in 30 minutes! Each baby, whether bottle-feeding or breastfeeding will feed differently just as adults eat differently. If every mother produces a different amount of milk and every baby eats at a different rate, how could all humans feed for 10 minutes on each side and get what they need? It all sounds a little silly when it’s put that way.
When you read the research and want to give the best advice to mothers, it seems like the following may be the best way to answer the age old question, “How long should the baby nurse?” Let the baby lead the way! Follow the paths of all mammals by letting your baby tell you when they’re hungry and when they’re finished, and, if they’re interested in side two. Most lactation consultants and breastfeeding advocates are trained to tell mothers to watch the baby’s signals.
Here are some standard tips for a new mother, including guidelines, but no restrictive rules:
Allow the baby to nurse on the first side until they’re finished. Moms can tell they are finished if the baby comes off the breast or is getting a little sleepy at the breast and the pauses between the groups of sucks get long. Then, we need to watch the baby again. If the baby continues to give hunger cues, mom can offer the second breast.
Did I just give breastfeeding another rule? No, because the length of time each baby feeds will be different. Mom will learn what is best for HER baby by watching HER baby rather than the clock.
One more thing….what’s the worst thing that can happen if your baby uses you as a pacifier for a little while? He will be comforted by one of the people he loves most in the world at his favorite place in the world.