UNDERMINING BREAST/CHESTFEEDING: HOW A BREAST/CHestFED BABY ENDS UP... Not

I've answered desperate calls from many families who are struggling with something they thought would be natural and easy: feeding the baby. As a new first-time parent, I struggled with it myself. My case, like many others, had less to do with medical obstacles to breastfeeding and much, much more to do with my perception of how breastfeeding was going compared to how I thought it should be going. I had a baby who nursed every hour, and I would have been just fine with it, were it not for the well-meaning family members and friends who admonished me not to "let him use me as a pacifier". Each time he cried out to be held, I picked him up and nursed him, and felt guilty about it, thinking I was feeding him too much.
Well, guess what? Those family members and friends were failing me. There's no such thing as nursing a baby too much. Babies are born to nurse! The problem is that our culture, having thrown breastfeeding by the wayside a few generations ago, has forgotten that babies are humans with instincts, emotions, and the ability to communicate. Our culture doesn't trust babies to know when they're hungry. Unfortunately, many parents armed with a lack of support and information get so anxious that their baby is nursing frequently that they think there must be something wrong with their milk, or their ability to make it. To these parents, one misinformed comment from a neighbor or one undereducated care provider could mean the end of the breastfeeding relationship. Here's what I mean.

Baby A was born in a hospital to Mama A. Mama A knew she wanted to breastfeed exclusively, and things went great. She had a large storage capacity, and Baby A was an Olympic-level nurser, gulping down 5 ounces of milk at every feeding and nursing every three hours during the day and sleeping six hours in a row at night by one month of age. (Of course, being an exclusive breastfeeding dyad, they didn't know- or need to know- how many ounces they were getting in a feeding. We get to know this because, well, I'm making it up.)

Just a few days later, Mama A's cousin Baba B gave birth to their baby, Baby B. Baba B knew they wanted to nurse exclusively, and things got off to a pretty good start. By three weeks of age, Baby B, a somewhat fussy baby with a big appetite, was nursing about every hour and a half during the day and every two or three hours at night. Baba B had a smaller storage capacity, providing about two ounces at a time, and Baby B always seemed to need both sides at every feeding. Baba B felt okay with this, although they sometimes wondered why their baby seemed to need to nurse so much more than babies they'd seen in movies and read about in parenting books.

After one particularly tiring night where Baby B woke to nurse every hour or two, Baba B was having lunch with Mama A and confided in their cousin about how exhausted they were. "I don't know, Baby B seems healthy and I feel like I have enough milk, but she nurses all the time and I'm getting so little sleep! Does Baby A nurse this much?"

Mama A responds, "Oh no, she's been sleeping through the night for weeks! She nurses every three hours like clockwork during the day. I think Baby B is just using you as a pacifier. Try having someone else take her for a while, or give her a Nuk to suck on and leave her in the crib so you can get some rest."

A seed of doubt planted, Baba B is convinced that Baby B should be nursing like Baby A. They buy a pacifier and start sticking to an every-three-hours feeding schedule. Baby B seems fussier than ever. Baba B starts to seriously wonder if they just aren't making enough milk. After a few weeks, Baba B notices Baby B isn't peeing as much as she used to and hasn't pooped in days. They head to the pediatrician.

The pediatrician weighs Baby B, whose weight percentile has dropped from the 30th percentile to the 10th. The pediatrician tells Baba B that they must not be making enough milk and should start giving an ounce of formula after every feeding. Baba B is disappointed, but worried for their baby's health and not seeing any other options, they go pick up a can of formula. 

What happened? Baba B and Mama A were both equally equipped to feed their babies with their bodies. They both had babies who could suckle and milk making tissue that functioned. They had two different babies with different temperaments, different appetites, and different nutritional needs. They had different storage capacities and different beliefs and anxieties.

Our two nursing dyads represent the wide array of normal, healthy feeding relationships that mother nature has created. One baby may grow and thrive on 22 ounces of milk per day spread out over 8 feedings; the baby next door may get the exact same amount of milk and fall rapidly off the growth charts, meeting a diagnosis of failure to thrive. Each baby's unique needs and each parent's different capacities for milk storage are the reason that scheduled, measured feedings don't work for many families.

Now imagine our story taking place in a world where natural infant feeding is the norm, and knowledgeable support is easy to find. The afternoon they're having lunch, a tired Baba B complains to Mama A about the sleepless night they had. Mama A has attended her local La Leche League group and remembers hearing about growth spurts; she has heard LLL Leaders say "watch your baby, not the clock," and she knows that on-demand nursing meets a baby's needs best. She tells Baba B, "You must be exhausted. Growth spurts are hard-it seems like she's nursing constantly, huh? You're a good parent, meeting her needs day and night." Baba B feels a little better. After a few days, the growth spurt is over and Baby B, secure and content with her needs met, surprises Baba B by beginning to sleep in four hour stretches. Two years later, Baby B is still nursing and has cute, chubby rolls proving the nutritional quality of the milk her parent once doubted was good enough.

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