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breast feeding is a very private and personal experience, says Caroline Flint. Midwives should be enablers rather than helpers `The two lie close in each other's arms, dark eyes gazing into dark eyes, breaths soft and panting as the erect, hot tissue searches for the soft, most, open orifice.' A description of lovemaking? It could be just that, but what if one of the two is only six days' old, or six weeks, or six hours? Then it is, of course, a description of breast feeding. The similarity between the two very intimate experiences is not only in the fact that the nipple is composed of erectile tissue and that the baby's mouth is open and moist, but that the breast feeding women releases oxytocin from the posterior lobe of the pituitary gland just as she does when she is in labour and when she is making love. Just like lovemaking, breast feeding is described as `natural' but it is interesting to note that in 1980 only 12 per cent of women were feeding their babies `naturally' by the time their babies were nine months' old, and that by four months' old (the DHSS recommended length of breast feeding) only 26 per cent of mothers were `naturally' feeding their babies.' What is the point of comparing breast feeding to lovemaking? We all know that midwives are trying to encourage breast feeding, and that indeed the prevalence of breast feeding of four-month-old babies has increased from 13 per cent in 1975 to 26 per cent in 1980'. Very few women going through the antenatal system miss out on having their breasts examined; many of them have advice on expressing colostrum, wearing supporting bras, rolling nipples, washing nipples, creaming or oiling nipples. Midwives all over the country are bent over nipples examining, advising and educating. Once the baby is born, midwives again see their role as a provider of `help' and 'education' for the breast feeding mother. The newborn baby is expected to `latch on' within the first hour following birth and although I applaud the time span, I question the way the `latching on' is accomplished. During the following days the baby is put to the breast frequently and, thankfully, nearly all hospitals now practise real demand feeding, that is, feeding whenever the baby wants. But what else does the baby receive in the hospital? Are we really helping women when they are breast feeding. Could we be perhaps termed as obstructive, or unhelpful? We should look at breast feeding as an intimate, physical experience between two people. Ask any mother and she will tell you that each of her children were different when breast feeding. `Johnny was so easy'; `Mary wasn't interested for days, and when she did suck, she sucked at a funny angle and made my nipple sore. I evolved a technique of feeding her lying down and then it didn't hurt'; `Justin stayed on the breast for hours at a time. Each time he dropped off to sleep I'd try to take him off, and then he began sucking furiously again'. Is it the same experience with each sexual partner a person has? Does every human being in the land make love in the same way? I suggest not. Likewise, it would seem rational that every baby in the land should breast-feed slightly differently and that the feeding of each baby is just that - the feeding of this baby - not the feeding of any baby. Think about the first experience of breast feeding; the woman lying or sitting on the delivery table, the midwife `helping' by holding the baby's head in one hand and the woman's breast in the other. Imagine if the first experience of lovemaking were the same, with an `expert' at the side of the bed organising the young man and the young woman, pushing them into the `right' position, compering the whole event: `Now, John come a little to the right, that's right, Jane, move your leg here, now John ...' Describing this ridiculous scene makes me laugh, but we do it all the time when a woman is starting to breast-feed. How useful is this sort of `help'? Would it perhaps be more useful, and indeed more of a boost to a women's confidence, if we left her and her baby (with her partner) and said, as we left to make the tea and write up our notes, `He looks as if he'd like to have a feed. Put him to the breast while I'm away'. The parents left to get their baby onto the breast can usually achieve this without any problems, and when the midwife returns, the baby has often been suckling for 20 minutes and the proud parents are beaming with pleasure because `they did it'.The greatest need of a mother is confidence in herself. We can affect her level of confidence by the sort of support we give her during labour, by the amount and sort of analgesia she (and therefore the baby) receives. A baby who has received little or no analgesia (or whose mother has had an epidural) is likely to be more alert and interested in breast feeding during the first few hours and days than the baby who has received large quantities of analgesics during labour. A newborn baby's head is very sensitive, and if someone holds it, it will instinctively root towards the hand, hence the 'struggle' noted when midwives hold the baby's head and clamp it to the mother's breast. So, I am suggesting that:: o breast feeding is an intimate, physical partnership which needs to be carried out (initially) in private by the two people concerned o the role of the midwife is not a physical or practical role but rather that of a `cheer leader': `Aren't you doing well?' 'Doesn't he enjoy it?' 'You feed your baby beautifully'. o the baby - this baby - should control the feeding, when, how long, how much. o everything that could reduce a woman's confidence in her ability to feed her baby should be moved - bottles of water or formula. o scales should not be strategically placed in the postnatal ward, for these also reduce a woman's confidence. Any midwife worthy of the name can tell if a baby is thriving. Finally, I am suggesting that we need to evaluate what we are doing. Can we leave women alone to get on with breast feeding and just help them with encouraging words'? Or is it better for us to be handling women's breasts (could this be so embarrassing for the woman that it could impede the release of oxytocin) and `fixing' the baby to the breast? Are we helping women to breast-feed? Or are we hindering with excessive interference? We shall only know when someone does a randomized controlled trial - could that be you`? ReferenceOffice of Population Censuses and Surveys (1982). Infant Feeding. London. Further Reading Messenger, M. (1982). The breast feeding Book. Century Publishing Ltd. Stanway, PA. (1978). Breast is Best. London: Pan Books. Kitzinger, S. (1979). The Experience of breast feeding. Harmondsworth: Penguin Books. La Leche League Book (1971). The Womanly Art of breast feeding. April 11, 1984 |
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