I recently attended a day of postpartum depression lectures. One of the
presenters discussed the brain changes during pregnancy and these changes being
specific to preparation for child care and infant survival.  It causes  an
increased sense of awareness, anxiety, etc in preparation for being very in  tune
to and aware of the needs of the baby--think survival of  species.   His
information coupled with other presenters made me  very aware of the importance of
what we do and say to a mother during labor and  delivery and the early
postpartum period as everything we say is being  filtered with a heightened sense of
awareness.  It also makes me  think that skin to skin, real of mother baby
togertherness from the  moment of birth, breastfeeding, and a multitude of other
behaviors we interfere  with during the birth of a baby plays a bigger role
than we may be aware of in  terms of postpartum depression, breastfeeding
success, adaptation to the role of  mother, etc.  If indeed it is true that the
brain actually changes during  pregnancy, than the stress of what we say and do
to mothers and babies coupled  with the attitude that it is normal -- even
while it feels so very wrong -- can  only add to mother's sense of distrust in
herself.

As for crying, ever check out Harvey Karp's website and the description for
why babies cry excerpted from his book?
_http://www.happiestbaby.com/book_excerpts.htm_ (http://www.happiestbaby.com/book_excerpts.htm)   The  idea is that
babies are not really communicating with caregiver, but only with  self, and
that the baby is not even trying to communicate at all--has  no idea he is
even sending a message.  That we are just accidental  eavesdroppers.  More in
line with what I choose to accept as a valid theory  is  what a pediatrician said
at the same discussion day on postpartum  depression---Baby cries for a
reason. That babies come born with a  competent system of communication and at the
moment of full term birth have  neonatal behavioral competences that allow
them to survive and to  develop attachment.  The cries are a form of
communication we should not  ignore.  Maternal response to cries affects baby's stress
levels as baby  has a sense of expectations being met, and it is very destructive
to a newborn  to not know what to expect.  He was discussing the impact of
ppd on newborn  mental health and physical responses in terms of maternal
response being  affected by maternal mental health. Listening to the presentations I
repeatedly  heard that the mental health of the mother impacts the health of
the baby.   That there are risks to not caring for ppd and the risks are for
both the mother  and the baby.  I also heard we are likely underestimating  the
impact  of ignoring the baby's cries when considering long term mental health
of  the child who will someday be an adult...

 Now, lets combine these two "theories"---mother's brain changes to  respond
to crying babies and baby cries for a reason.  What happens when  mother is c
onditioned to ignore a physical response -- the desire to answer her  baby's
cries and her physical pull to put her baby to breast (thinking of  Odent's
work)?  What happens to the brain of the baby when all the  adaptations for
expectations are skin contact and breastfeeding are ignored  repeatedly? Can't be
good for a mother's balanced brain activity to be  constantly in conflict with
that "mother" mental pull that is  biological and cultural expectations.  And,
I can't see how it would  be good for a baby to be constantly denied that
which it expects to receive in  order to survive.

I wonder what would happen if we started over.  Created a birth  environment
where normal was respected -- even if not always possible - and the  attempt
to maintain it was always  considered for all newborn care, even  the most high
risk.  Breastfeeding is a big piece of this picture. What  if  the research
of brain change is true,  and mothers'  brains  are altered during pregnancy to
respond?  It seems to me that for  species survival, offering the breast
would be the 'normal'  response.  What if we understood more about the brain's
response to denial  of biological adaptations? What if we understood more about
chemical  balances and hormonal balances being affected by interference with
biological  norms?  Is it possible we may come to the place maternal/infant
health  care that recognizes and respects the importance of  the technology and
life saving medical advances and at the same time recognizes and  respects the
emotional and mental health of mothers and babies.  Maybe  this would be a
step in the direction of breastfeeding being seen not only as a  choice, but a
normal phase of the female reproduction and human infant  adaptation all in the
name of healthy human survival.

 When I consider the impact of choices and uncontrollable events on  the
lives of babies, I can't help but think what an adaptable creature the  human
really is.

Just my morning ramblings....
Pam MazzellaDiBosco, IBCLC
Florida, USA


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