Welcome back. This is
the second part of a two part series on the role of the father in
breastfeeding. In the first article we
explored each team member’s role in the breastfeeding relationship. We talked about Mom’s job, which is to put
the baby to the breast, to offer the breast, and love the baby. We talked about the Baby’s job, which is to
put the breast in his mouth, suck and swallow until satisfied, and love mommy
and daddy. We talked about Dad’s job
which is to take over the job of the lactation consultant when the family goes
home. The father is the one who will be
available to answer questions at 3 AM.
The father is the one that mom trusts, she listens to her partner much
better than she listens to her lactation consultant. Many mothers struggle with confidence when
breastfeeding, they doubt the baby’s desire to breastfeed, they doubt their
families support for breastfeeding, and most of all they doubt themselves and
their abilities breastfeed. A new mother
struggles with confidence almost every day and her shaky confidence is easily
destroyed by a doubting father. When you
say something stupid, like “I don’t know honey, maybe we need to give him a
bottle”, you have just damaged your family’s chances at breastfeeding
success.
So, if you’ve come this far, your still with me and it’s
time to learn how to breastfeed. I break
it down into three simple steps. 1) When
does the baby need to eat? 2) How does
the baby eat? 3) When is the baby done eating?
It really is that simple, so let’s dive in.
When does the Baby need to eat? First thing you have to understand is that in
all my years working with families, I’ve never met a baby that read the rule
book before birth. A baby does not eat
for 10 minutes on each breast every 2-3 hours.
What nonsense! Babies are not
born with watches, and even if you give him one, he can’t read it anyway. When a baby has stress (hunger, cold, wet or
dirty diapers, pain, or loneliness) he will show you some very predictable signs. He’ll curl up his hands and feet and bring
them to the center. He’ll bend at the
knees and cross his feet or put his heels together (that’s called centering
behavior). He’ll start to turn his head
and may suck on his hands. Eventually
he’ll start to fuss and finally cry. All
of these are stress signs. Sometimes
he’ll be hungry, sometimes lonely; but when he does those things he is asking
for you to pick him up and tend to his needs.
Since you won’t know what he wants by looking at him, I always recommend
you start in the kitchen (AKA – the breast).
If he’s hungry, he’ll take the breast when you offer it. But never insist that a baby “has to be
hungry” just because it’s been a while since he’s had the breast, and the
opposite is true as well. Don’t
automatically assume he can’t be hungry just because he only ate an hour
ago. Babies are unpredictable, but when
you offer the breast, he’ll eat if he’s hungry.
As a general rule, newborns eat 8-12 times a day, usually in clustered
groups of 3-4 times in a four hour period, they then take a 3-4 hour nap and
start over again. Don’t count on it, but
know that while no two babies eat on the same schedule, very rarely will a baby
actually eat for 10 minutes on each breast every 2-3 hours, as most books would
suggest.
How does the baby eat?
This is a tough one; every baby is different, just like every person is
different. But there are a few simple
principles that you can follow. When
baby is ready to eat and he’s in the kitchen, he will stretch out his hands,
move the breast to where he wants it, open his mouth VERY wide, and take the
breast deep into his mouth. He’ll latch
on well, he’ll suckle in bursts of rapid sucks followed by a short pause, you
may hear a soft quiet swallowing sound, and then he’ll do it again. Sometimes he’ll appear to be sleeping, as he
lies peacefully on the breast while holding the breast in his mouth. Don’t be fooled, babies don’t really sleep on
the breast; they rest and wait for their drinks to settle in their stomach. I am fond of saying “Only college students
and Army Privates like to chug” everyone else takes a few sips then puts their
drink down, then start again. Don’t
expect him to chug his milk and get it over with quickly, he wouldn’t expect
the same from you.
When your baby is on the breast you need to make sure he is
latched on well and that he is transferring milk well from mom to baby. Every time your baby latches on, you will
need to look for signs of a good latch, and here they are:
1)
Nose and Chin touching the breast. He should burry his face deep in the breast,
never try to pull the breast away from his face because that will pull the
nipple away from him mouth, or change the shape of the breast in his
mouth. Never fear that he will suffocate
on the breast. First, remember, he isn’t
stupid, he won’t suffocate for one more drink of breast milk, if he can’t breathe,
he’ll just turn his head or pull away.
Second, have you ever noticed the creases on the side of your nose and
how they tend to run up to your eyes?
Have you ever noticed that there is a dimple on the side of your head
where your eye sockets are? That is a
continuous channel from the nose to the side of the head that I call “The Baby Snorkel
System”. Air moves from his mouth, to
his eyes, under his eyes and out the side of his head. If you don’t believe me put your face
underwater, cover your face with your hands and blow air out of your nose,
you’ll see the air move out of the side of your head.
2)
Full Round Cheeks without dimples. If his mouth is full of breast, his cheeks
are full of breasts. If you see dimples
on his cheeks or creases around his mouth, he does not have the breast deep in
his mouth and he is creating a vacuum of empty space, and he is hurting your
lovely bride.
3)
Wide Open Jaw. The infant has a small mouth and he has to
open that mouth VERY wide to get all that breast tissue deep into his
mouth. Get ready, here’s where you get
to measure something. If you measure the
angle from his nose, to his ear, to his chin that angle should be greater than
60 degrees, but 90 degrees is even better.
I recommend using your fingers, put your index finger on the nose, your
palm on his ear, and your middle finger on his chin, and measure that
angle. 45 degrees is a closed and empty
mouth, and that hurts!
4)
No Pain.
NO PAIN! NO PAIN! NO PAIN! Did I
mention it shouldn’t hurt to breastfeed?
Traditionally, nipple pain in early breastfeeding was considered normal
and unavoidable. That is a myth whose
time is long past. New understanding of
the anatomy of breast milk structures in the nipple and areola shows that there
is no fat or cushion in the nipple and that all cushion is held back on the
areola. When the infant pinches the
nipple with his mouth or tongue your wife will get pain, which is exactly the
same thing that will happen if you pinch the nipple with your thumb and
forefinger. Pinching the nipple is
always a bad thing and mom wouldn’t let you
do it either! If you can’t get away with
it, neither should baby. Not only will
the baby hurt his mother, but he will also not be able to effectively bring
milk out. When you pinch the nipple, you
bend the tubes that bring down breast milk.
Just like any other straw, if you bend it you can’t drink from it. Don’t let the baby bend those tubes or pinch
the nipple. If your wife has nipple
pain, you need to fix the latch immediately, and if you can’t, you need to get
in to see a lactation consultant as soon as possible.
5)
Flared Lips, Up and Down. In order for a baby to take the breast deep
in his mouth he will have to flare his lips as he opens his mouth widely. His tongue will extend and push out his lower
lip, and he will wrap his lips around the areola. If there is a latching problem it is often
failure to flare the bottom lip. All
that being said, when he is properly buried into the breast you can’t see his
lips. Know that if everything else is
okay, the lips are probably okay. But if
there is pain, dimples in the cheeks, or a narrow jaw, you will need to help
your baby open his mouth and push his bottom lip and tongue out.
But how do I do that? One may ask. Don’t worry I’ll show you. Now, I’m a soldier, I’ve been a soldier my
entire life, and a soldier I use soldier analogies when I teach. If any of you have ever served in the Armed
Forces, you will get this next bit well.
If not, I’m sorry in advance.
When a baby has a bad latch, it is almost always a double feed. You have
two rounds in the chamber at the same time (in this case, breast and lower
lip). And just like any other double
feed, you’ll have to pull SPORTS (slap, pull, observe, release, tap, and
shoot). If you’ve never been in the
military, don’t worry, just remember SPORTS, guys like sports so we can use
that to help you remember the steps to fixing a bad latch.
S – Slap – Put your hand on the
baby’s back and push him toward the breast (don't actually slap him, just press him into the breast).
P – Pull – Reach in between the
chin and the breast and pull down on the baby’s chin to elicit a rooting
reflex.
O – Observe – Does it work? Does the jaw open, do the cheeks fill and
round out, do the lips flare, and does the pain go away?
R – Release – let go of the chin
and let the baby suckle and test the new latch.
T – Tap/Try again – Repeat the
first four steps two or three times to see if you can correct the bad latch.
S – Shoot – Darn it! We have to
take him off the breast and try again.
If you can’t fix the latch with the basics of SPORTS you are
going to need remedial action. You’re
going to have to drop the magazine (take the baby off the breast), clear the
chamber (calm the child then elicit a rooting reflex off the breast to
encourage a VERY wide open mouth), and reload (put him back to the
breast).
Eventually these steps will almost always help solve a bad
latch. Very rarely you may find that
even though you do everything right your baby will not latch correctly. He may have chosen to sleep rather than eat, he
may be over stimulated, or he may just need an experienced hand to help him
out. Give him a break, let him rest for
an hour or so, and try again. If he ever
goes 24 hours without eating, get in to see a lactation consultant right
away.
Finally, When is my baby finished eating? When baby is finished eating he will relax
his hands, release the breast, pull away from the breast, and fall into a deep
sleep that I call “The Milk Coma.”
Remember, your baby can’t tell time.
Some babies will finish the breast in 10-15 minutes; some will finish
the breast in 45-60 minutes. Both babies
will have taken the same amount of milk, and that amount is “ENOUGH”. There is no easy way for you to measure how
much a baby eats when he is on the breast, but know that the actual amount of
ounces he drinks is immaterial. What is
important is that he goes to breast interested in feeding, and that he pulls
away content, relaxed, and sleeping. A
baby that is satisfied after feeding, growing steadily, looking healthy and is generally
a happy baby, is almost certainly getting “enough” to eat. The number one concern of new mothers is that
they do not make enough milk. Try not to
worry about it, keep offering the breast to the baby, and he will always get
enough to eat.
Now that we’ve covered feeding, let’s talk about sex while
breastfeeding. You may be afraid to ask,
so I’ll tell you. Breastfeeding (and for
that matter, parenting) will impact your sex lives. Both of you need to know that some mothers
have an increased libido (thanks to repetitive oxytocin surges), while others
have a decreased libido (thanks to prolactin and a decrease in estrogen). Fathers may face problems with the “Madonna
Complex” (She’s a mother now). All of
this will impact your sex live, but perhaps what is most important is for
fathers to understand that all aspects of parenting, are demanding, physical
work with only short bursts of sleep interrupted by a newborn that demands
attention at inconvenient times. Mom
will need constant support and help from her lover. The more help she can get from her husband,
the more energy she will have for other activities. In other words “You’ve got to give a little,
to get a little.”
So there you have it; breastfeeding from a man’s perspective. Fathers are powerful allies contributing to
breastfeeding success. Do not allow
yourself to be excluded from this time in your child’s life. Study and learn, roll up your sleeves and get
in the game. Your family stands a much
better chance of success if you actively support breastfeeding and actually
help your wife breastfeed.
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