What to Expect from Your Breastfeeding Newborn
By Ann Calandro, BSN, RNC, IBCLC
It’s no wonder that new mothers are confused about breastfeeding. What opportunity do they have to understand real breastfeeding babies, not the pretend ones on TV or the fictional ones in stories? Not the formula-fed infant of their neighbor.
Let’s see. On TV, infants are mostly upstairs in their cribs, sleeping peacefully while Mom lives her life largely unchanged downstairs. In stories they are much the same, sleeping 22 out of 24 hours a day, peacefully eating and cooing the rest of the time.
The Formula Effect
In our culture, mothers have been accustomed to babies who are formula fed, who behave very differently from babies who eat naturally. Formula is an artificial food, and it causes babies to act in artificial ways. Babies who drink formula receive in very short order a large amount of liquid that is very difficult to digest. After a formula bottle and a few big burps, babies sleep for several hours before they feel hungry again. Hmm… This sounds very nice; Mom can get lots of things done. Perhaps.
However, inside, Baby is dealing with an unnatural food that is very hard to digest and takes a very long time to move out of his stomach. In any case, many new mothers have come to accept that this is the way their own baby will behave. Not so with breast milk.
Breast milk is natural and digests very quickly – usually within two hours. Therefore, breastfed babies eat often. In the early weeks, they may eat eight to 20 times a day – or more. It depends.
As a lactation consultant, I frequently hear moms say, “Well I tried to breastfeed my first child but they always wanted to eat, and my milk could never fill them up like formula did. They were always hungry.” Get it? The formula makes them feel very full, but is that good for them? Not really. Formula is deficient in all immunological properties.
I then ask the mothers, “Before you changed to formula, was your baby gaining weight well and having plenty of wet diapers and bowel movements?”
“Oh, yes,” they say. “That was going well.” I have come to understand that the reason these moms quit is not that their baby is not growing well or that they did not have enough milk, but because they didn’t want to feed as often as the baby needed to eat and felt that by switching to an artificial food, the baby would be “happier” and “more content.” Their baby would behave more like TV babies. Their perception was that something was wrong because their babies ate often. Perhaps that feeling was reinforced by “helpful” friends or family members.
I make it a point to discuss normal newborn physiology in my prenatal breastfeeding classes so that parents understand what is natural for babies. First I teach them that newborns are really very immature at birth. Many babies are induced earlier than their due dates so that they are even less mature. Boys are less mature at birth (and throughout life) than girls.
Dr. Marshall Klaus says that human babies are the least developed of mammals, take the longest to mature and need a lot of holding and stroking, especially in the early months. Babies need the closeness of human contact, just like baby puppies or kittens. No book could convince Mama Cat that her kittens would be better off sleeping far away from her!
Why then do we expect human babies, who are even less mature for longer periods of time, to feel safe and calm in their crib in their room? Every afternoon when I do follow-up telephone calls to new mothers, a mother will say to me “My baby has his days and nights mixed up.” I reply that when it is dark and quiet, babies feel unsafe in the early days, not knowing if a bear or a wolf is close by and is going to attack, so they wake up and express their fear. Good for them! It is a survival mechanism.
Some experts believe that sleeping through the night is not a healthy habit, because frequent night waking is a normal safeguard against SIDS. Only when close to larger and dependable caretakers do babies feel relaxed. In the early months, if Baby can’t see you, you don’t exist for him. Your caring response is crucial for healthy growth and development.
Parents also need to know about baby stomachs. They are very small at birth – about the size of a cherry. Mom makes that perfect colostrum. When Baby nurses he will get a teaspoon or two in the first day, and the amount will increase gradually. When Mom’s milk increases on the third day or so, Baby’s stomach is still small, so she drinks her fill but then needs to sleep a bit. Breast milk digests quickly, so Baby needs to eat again soon. There you go. Understand why babies eat so often in the early days?
Hospital-born babies lose weight the first two days, so they also have some catching up to do. Most regain their birth weight by a week or two and then need to double it by 5 or 6 months and triple it by a year. How much would you have to eat to do that?
Another comment I frequently hear is: “He’s already spoiled. I pick him up when he fusses, and he stops crying. I’m afraid he has me trained already. I know I shouldn’t pick him up.” Why not? Who says?
Mothers are sometimes berated by family members and visitors for following their normal and natural instincts of responding to their own babies’ needs. It is a sad world when we worry about training a newborn to be happy alone. Of course he needs to be picked up! He is not mature yet, certainly not capable of thinking, “I believe I will make her get up out of bed just for fun and pick me up.” I worry about mothers who do not respond to their babies. When babies are left in their cribs to cry or left in the nursery with nurses for hours on end, I wonder what is wrong.
Crying is not normal either. Despite the sage advice of some grandmothers, crying isn’t good for Baby’s lungs. When you hear your baby cry, your heart will tell you so. Crying causes your baby’s cortisol levels to go up, his blood pressure to go up and his whole life to become unbalanced so that he doesn’t feed or relax well. When your baby cries, your instinct is to do everything in your power to solve his problem so that the crying will stop. Newborn wailing is meant to be very grating and to spur you into action. Most times with breastfeeding babies, your touch or your breast is the instant solution whether baby is thirsty, hungry, cold or afraid. Think you might need a magic wand? You have been blessed with two!
Think about the size of your baby’s brain. According to Sharon Heller’s book, The Vital Touch: How Intimate Contact With Your Baby Leads to Happier, Healthier Development, human babies’ brains are 25 percent of the size they will be as adults. Since babies must fit through the birth canal, their brains must wait to grow until after they are born. She says that, “in a sense, we’re all born premature, not ready for life until 8 or 9 months of age, when we begin to crawl and venture forth on our own.” Only the marsupials, such as kangaroos and opossums have less mature babies, and they remain attached to Mother for a long period of time to make up for lack of time in the womb.
Moms Need Babies
OK, so Baby is immature and needs to eat a lot. What else? I forgot to say that mothers also have needs. Mothers need to be with their babies just as much as their babies need to be with them. Ever see a nursing cat leave her babies unattended more than just a few moments when they are brand new? Follow your own instincts as a mother – and as a mammal. Love and hold your baby as long as you want. Forget the nursery in the hospital, and keep your baby close to you. You will both be happier.
Wander down the hall in a hospital maternity ward in a baby friendly hospital. All is quiet. Babies are with moms, content and being cared for one on one. Check out a hospital with a central nursery where babies spend time away from their mothers. You will hear crying, screaming, sobbing babies, fearful and unsure of their safety. As adults, we know they are safe. They don’t.
Secrets to Success
In order to be successful with breastfeeding, it helps to know about the needs of normal babies. Breastfeeding babies cue by rooting or chewing their hands when they are hungry. Successful breastfeeding mothers respond to early cues and feed before their babies cry.
Breastfed babies don’t eat on schedules. Breast milk is fully digested in an hour and a half to two hours, so babies respond to their empty stomachs by cueing for more. Trying to schedule a breastfeeding baby or to restrict how long he can eat is a recipe for breastfeeding failure.
Infants have hunger needs and touch needs which must be met. Perhaps formula babies can be scheduled more easily, since their food digests slowly. In fact the whole idea of scheduling has come from formula-feeding practices. Breastfeeding is totally different. Many breastfed babies will fall into a pattern after a few weeks, going longer between feeds, becoming more efficient at eating. Growth spurts may interrupt the pattern, but babies will fall back into their pattern after the growth spurt.
Sleep is also interesting. All around the world babies and children sleep with their parents or their brothers and sisters. In the United States, solitary sleep is advocated by physicians and society in general and is thought to foster independence and self-sufficiency. Other societies look upon infant separation for sleep as child neglect. Very interesting. Are the babies in the United States different from babies in other places?
Knowing what we know about the immaturity of newborn babies, is sleeping alone physiologically natural for babies? Many mothers who keep their babies close at night can attest to the fact that their babies sleep better and longer if they can sense the presence of their mother. Understanding Baby’s lack of maturity, is this a surprise?
Breastfeeding is the act of allowing the mother and baby to interact in a natural way, listening to each other’s needs. It is an understanding that mothers need babies just as much as babies need mothers. Breastfeeding is not something we teach babies; it is something babies teach us. We have been a bottle-feeding society for a long time. It is nearly impossible to fit breastfeeding into formula-feeding expectations. Mothers who try to often find themselves formula feeding, and they don’t even know how it happened.