I vividly remember being at a breastfeeding support session, when a fourth-time mother walked in and proclaimed, “I have successfully breastfed three babies but it's not working this time!” before she broke into tears.
What’s the missing piece?
Dr Pamela Douglas points out many reasons why this might be the case: facial structure differences, body changes that impact fit and hold and the baby’s temperament are all valid reasons why a second, third or even fourth-time mother can find breastfeeding hard. Think of it as two brand new puzzle pieces coming together.
“How to fit a woman and her baby together is still a research frontier” Dr Pamela Douglas
96% of Australian Mothers start breastfeeding, with only 39% of babies exclusively breastfed by 3 months of age (Australian Breastfeeding Association link). So why do parents turn to formula? The main reasons are pain, supply concerns, unsettled behaviour, and lack of support. Dr Douglas adds that the huge issue around supply highlights the lack of clinical breastfeeding research. She believes the reason parents are introducing formula is a health system problem. The research indicates that women want to breastfeed but when obstacles arise, it makes it incredibly challenging.
The let-down Mothers don’t need
“Women try so incredibly hard to make breastfeeding work, there is such raw heroism that I see over and over in the clinic” Dr Pamela Douglas
The reason why there’s such a drop off is not because women aren’t trying hard. A lot of breastfeeding and fussiness at the breast interventions come out of outdated mechanical models. “The health system is letting women down, there is a lack clinical skills to deal with the breastfeeding and we are not prioritizing this research” adds Dr Douglas
Another hurdle is the overmedicalization of mother baby care. Dr Douglas recently publishedan article detailing the chronic overdiagnosis of thrush with nipple pain. Why is this occurring? According to Dr Douglas, the health profession has run out of tools, they do not know how to pick up the repetitive microtrauma that comes with breast tissue drag. Her approach resolved the underlying issues of breast drag, allowed women to begin to heal, continue breastfeeding and avoid long courses of anti-thrush medication.
“Unfortunately, because so many of our breastfeeding problems are not picked up, it can seem as though babies become more settled with formula” Dr Pamela Douglas
Taking the pressure off new parents
She warns that telling parents to feed every 3 hours, gives them the idea thatnow is feed time and Ihave to get milk into my baby, or they won't gain weight. But we must be mindful that there are plenty of times when the little one does not want to be at the breast, they want to see the world and are hungry for a sensory adventure. Trying to get more milk in when the baby is not ready can quickly manifest as fussiness at the breast.
What can women do? Dr Douglas suggests a good place to start is frequent, flexible feeds knowing that you can’t overfeed a breastfed baby. You can offer 10 minutes after you just offered but also not feeling the pressure to have a long feed if you have a coffee catch up or an older child needs you. Frequent and flexible offers without pressure on any feed can be something worth knowing if your baby is fussing a lot at the breast.
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Did you know that all our FYC Doulas have undertaken the Milk + Moon program and can assist with integrating this into your family.