We know that the balance of hormones in the body is disturbed by many factors, including nutrition, stress and exercise. In fact,
we could just say stress is the factor, because poor nutrition and lack of exercise are stresses on the body. I would argue that pregnancy and lactation are NOT stresses on the body, unless that body is already stressed in some other way. As I see it, we have culturally come to accept that pregnancy and lactation are stresses and we treat them accordingly. The natural response to stress is to attempt to minimize it and this is how we approach our reproductive lives. But, the premise is invalid and indeed both pregnancy and lactation provide many positive opportunities for the organism from normalizing breast cancer risk to creating a protective mechanism in the mother's brain through fetal stem cell migration. In other words, we are biologically rewarded ( not to mention the emotional and psychological rewards). Under these circumstances, birth and feeding pretty much happen.

I think that our cultural impositions on this process are extremely dangerous, although perhaps not more so than the biological imposition that environmental toxicity has created. When the stresses of obesity, toxicity, malnutrition, sedentary lifestyle and cultural expectations are imposed on the dyad, we have no choice but to make modifications that optimize every possibility that the baby is a "perfect" candidate for breastfeeding in the modified, feed-every-three-hours, sleep alone, learn-to-be-independent mode. I think a lot of interventions are directed toward accomplishing this goal. 

It is so interesting to me how many people will find stray baby animals and "nurse" them to health (or at least attempt to) by unquestioningly recreating as much of the biological norm as possible. Frequent feeding, holding or carrying, warmth--whatever can be done. Rarely does anyone approach such infants with the attitude that they must manage with fewer feedings, less contact and so on. We optimize the environment to suit he infant, not the infant to suit the environment. Yet, we do just the opposite with human infants.

The biggest of these is overfeeding. Overfeeding allows babies to "sleep longer". Longer than what? Longer than what is good for them, of course. Overfeeding gives mothers more time. Time to be away from their babies. In all of this, we are asking the mechanism of lactation to modify itself to an outer limit of possibility. So, as much as stresses create hormonal imbalance, wouldn't we also imagine the stress of pushing the envelope of lactation would take its toll? The question would be, by what markers can we see if a price is being paid? Childhood obesity? Premature return of menses? Chronic disease in mother and child as he ages? Emotional costs?

So, what does all of this say about the information we provide to moms? Feed a minimum of 8X per day. Babies take about 30 oz per day. Well, that would mean at least 4 oz per feeding, at the lower limit, wouldn't it? What about test weighing? Whenever I hear test weights bandied about, the expectation is always for babies to remove at least this much milk per "session". Working moms certainly have an expectation of pumping a significant amount of milk per session, so as to have enough to feed their babies. How does one apply the data then--if a mom can pump 8 oz, why should her baby only take, say 2 oz at a "feeding"? I wonder all of time about our language here. 

Someone asked recently how breastfeeding became rocket science? I think it became so when we stopped just doing it and started trying to control it. Now we have so many women who struggle to make milk (the "right" amount up or down), so many babies who struggle to feed and a culture that ignores biological imperatives. What to do? I think talking in terms of the physiological norm and the risks of ignoring it may lead us to both a better language and a better approach to the problems we and our clients encounter.


Jennifer Tow, IBCLC, CT, USA
Intuitive Parenting Network LLC

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