Is Early Breastfeeding Ever “Impossible”?

Liam, 5 days old

Even before I got pregnant, I knew I would one day exclusively breastfeed my baby. As I researched the advantages of breast milk over formula during my pregnancy, I hoped that my son Liam would have no trouble latching on and that my milk would come in smoothly a few days after delivery.

Luckily, Liam has done an incredible job so far and I am convinced that it has a lot to do with the way he came into the world.

Over the past nine months, I spent hours researching natural childbirth and what the possible obstacles might be for me. Could breastfeeding not work out for me? I also became very interested in the correlation between epidurals and breastfeeding. Why did so many women I know who received epidurals struggle with breastfeeding? According to them, either their milk didn’t come in early enough and they needed to supplement or fully switch to formula or their babies wouldn’t latch on effectively at birth. This seemed surprising to me considering that there is nothing more natural than a baby latching onto his or her mother’s breast.

Although the topic is still very new and not many studies have been conducted to date, it is no secret that many people involved in the conversation have an interest in continuing to promote epidurals. According to the article “A Look at the Research: The Link Between Epidural Analgesia and Breastfeeding”, “caregivers who are unfamiliar (and therefore uncomfortable) supporting ‘noisy’, mobile and ‘demanding’ women (who are laboring without an epidural) are perhaps unlikely to want to change their more convenient practice; anesthetists have their livelihood to think about; drug companies which manufacture drugs such as fentanyl also have enormous profits to lose should women decide that epidural is, after all, not ideally conducive to breastfeeding success.”

Furthermore, here are a few things that may interfere with early breastfeeding, the most crucial time to establish a nursing relationship between mother and child:

• Epidurals are associated with a general medicalization of birth (since they usually and/or frequently involve IV lines and urinary catheters, as well as electronic fetal monitoring and ongoing monitoring of blood pressure) and this may contribute to greater maternal discomfort postnatally, meaning that breastfeeding could be affected.
• Epidurals are known to be associated with a higher rate of instrumental delivery and caesarean.  Postpartum perineal discomfort, or pain as a result of abdominal surgery, will also inevitably make breastfeeding less comfortable, and therefore less likely to occur.
• Epidurals can influence the fluctuation of hormone levels that play an important role in breastfeeding. A study conducted by Handlin et al (2009) found that medical interventions in connection with birth influence the activity of the hypothalamic-pituitary-adrenal axis 2 days after birth. (Adrenal gland activity, which is dependent on pituitary gland activity, which in turn is dependent on the activity of the hypothalamus is affected.) As a result of this influence, hormonal production is likely to be compromised, which will of course affect the success of breastfeeding, which depends on the release of the hormones oxytocin and prolactin. (scienceandsensibility.org)

I decided to go the natural route (without pain medication) because of these reasons, but also because I know that breastfeeding will benefit both Liam and me in the long run. Here are a few advantages of breastfeeding your baby, according to webmd.com:

• Breast milk provides the ideal nutrition for infants. It has a nearly perfect mix of vitamins, protein, and fat — everything your baby needs to grow. And it’s all provided in a form more easily digested than infant formula.
• Breast milk contains antibodies that help your baby fight off viruses and bacteria.
• Breastfeeding lowers your baby’s risk of having asthma or allergies. Plus, babies who are breastfed exclusively for the first 6 months, without any formula, have fewer ear infections, respiratory illnesses, and bouts of diarrhea. They also have fewer hospitalizations and trips to the doctor.
• Breastfeeding has been linked to higher IQ scores in later childhood in some studies.
• The physical closeness, skin-to-skin touching, and eye contact all help your baby bond with you and feel secure.
• Breastfed infants are more likely to gain the right amount of weight as they grow rather than become overweight children.
• The AAP says breastfeeding also plays a role in the prevention of SIDS (sudden infant death syndrome). It’s been thought to lower the risk of diabetes, obesity, and certain cancers as well, but more research is needed.

And what about for the mother?

• Breastfeeding burns extra calories, so it can help you lose pregnancy weight faster.
• It releases the hormone oxytocin, which helps your uterus return to its pre-pregnancy size and may reduce uterine bleeding after birth.
• Breastfeeding lowers your risk of breast and ovarian cancer. It may lower your risk of osteoporosis, too.
• Almost all mothers who are fully breastfeeding their babies are free of menstrual periods for the first six months.
• Since you don’t have to buy and measure formula, sterilize nipples, or warm bottles, it saves you time and money.

According to the Time Magazine article “Why New Mothers Stop Breast-Feeding”, studies found that women who worried from the start about their ability to nurse their infants were more likely to switch to formula sooner than those who didn’t have these concerns. After conducting over 2,700 interviews with 532 first-time mothers, researchers found that “over half of these women were worried about their babies’ ability to latch on, while 44% were concerned about breast-feeding pain, and 40% about their capacity to produce enough milk to nourish their infants.” The controversy about breastfeeding in public is an added weight as well.

Breastfeeding is a learning process for both mother and child. No mother should give up on it because formula is “easier” when the benefits of breastfeeding are so great. Why are so many women so quick to say that breastfeeding didn’t work for them? According to breastfeedingbasics.com, only 1-5% of mothers who give birth are unable to produce enough milk. “If you mean the number of women who are unable to produce enough milk to feed their baby exclusively breast milk, that’s going to be in the high end of that range. If you are talking about the number of women who aren’t able to lactate, and produce little or no breast milk, the numbers are much lower.”

A lot of it has to do with being educated about your options. If you cannot produce enough milk to continue breastfeeding as long as intended, you have the option to use a breast pump, tube feeding devices, and delivery of supplemental feedings (whether expressed milk or donor milk from a milk bank). Make sure that you are fully aware of all of your options before you decide to stop.

From my experience, if you can make it past the first few awkward holds (I didn’t know where to put my arms/hands) and latches (sometimes it does hurt a little if your baby doesn’t latch on a good amount of your areola), it becomes incredibly satisfying to nurse. Your baby will get the hang of it, and guess what? So will you.

After all, we are mammals and it is exactly what we are meant to do.