Hypothesis in breastfeeding: Immediate Breastfeeding?
Andreine Bel <[log in to unmask]>

Immediate breastfeeding, a relatively recent leitmotiv, seems to be a
"must" in the "natural" approach of birthing and the hobbyhorse of all
midwives and doctors wanting to get as close as possible to "nature".

Nevertheless, a delay of one or two days in breastfeeding seems to be still
commonly practised in the world.  In a medical environment, this custom is
associated with the separation between the newborn and her mother for many
reasons claimed by interventionists.

However, when I read or ask about the history of breastfeeding in France, I
realise that this delay has since long been customary in homebirth, and
that it is one of the few habits that were brought by midwives into the
hospitals.

Besides, in my recent research on Indian midwifery, I found the same custom
in remote rural areas of India (Maharashtra, Bihar), the ones which have
not yet been influenced by allopathy, obstetrics (and Western "experts" in
"natural" birth!) and whose women take special care in staying with their
babies day and night.  These people belong to what Michel Odent might call
the "environmentalists".  All women I met or interviewed (including
ayurvedic doctors) were categorical: the first thing to be given to the
baby is generally a small quantity of water with honey, brown cane sugar or
goat milk.  This for one, two or three days depending on communities and
regions.  A survey involving twenty five field-based non-government
organisations (NGOs) in eleven different states of India provides details
about pre-breastfeeding which corroborate my own investigation.  (Vd. Smita
Bajpai & Mira Sadgopal, "Her Healing Heritage", Ahmedabad: Chetna, 1996,
p.136).

Still, the fact that a delay is or was practised in France, so widely in
India and possibly in other countries (the ones out of reach of medical
care, according to a Mexican friend) is certainly not for me a good enough
reason to adopt this custom.  I sincerely wish to look with new eyes to
each and every event during a delivery!

When my son was born at home, I was as close to him as one can dream of.
He was skin to skin between my breasts, there was no interference
whatsoever, and I did not have anybody to show me or him what to do.  Each
cell of my body was awake, he was there, peaceful and attentive.  Indeed,
he had the sucking reflex from the beginning, which I checked.  But he was
not hungry.  He did not try in any way to suckle colostrum before the
placenta was born, nor later, until he rejected his meconium.  For two
days, waiting for him to be hungry, I gave him teaspoons of water with a
few drops of lemon and honey.

Then, he took breast, calmly.  He was ready, and my breast as well.  Twenty
years later, my friend's new-born girl reacted the same way.  She also was
born at home, with no outside interference.

Now, let us examine the arguments given for immediate breastfeeding.

Taking from my enquiry
<http://perso.wanadoo.fr/bel/dais/daicomp.htm#feeding>, in brief:
1- the reflex of sucking is ensured,
2- colostrum benefits to the new-born,
3- it helps for the meconium to be evacuated,
4- no risk of harm from foreign element,
5- stimulation of the mother's nipples, which in turn facilitates the
expulsion of the placenta, the contraction of the uterus (so important for
so many reasons), and the flow of colostrum and milk,
6- it allows or facilitates the bonding between mother and child.

1- The reflex of sucking is ensured.

It is well known that the reflex of sucking is spontaneous for a mature
new-born, if no drug has been given to her nor to the mother during the
delivery.  If this condition has been respected, there is normally no need
to ensure this reflex.  Moreover, in India again, ayurvedic doctors suggest
putting a drop of honey on one's finger and giving it to the baby to suck
and indulge the taste of sucking.  Poor people who cannot offer honey give
plain cane sugar molasses.

2- Colostrum benefits to the newborn.

It is precisely because colostrum is so important for the health of the
baby and future adult that it should be assimilated in the most proper way.

To my knowing, colostrum lasts for two or three days, then is replaced by
milk, whether the stimulation of the breast happens immediately after birth
or one or two days later.

With no early stimulation, it takes about two or three days for the
colostrum to flow, the same average time that it takes to the baby for
pushing out the meconium.

When the early stimulation is natural, so to say when the newborn eagerly
searches for her mother's nipples, there are certainly some good reasons
behind it.  The baby might have already expelled the meconium, the early
intake compensates for some previous imbalance, or it points at specific
tempers, baby's and mother's.

In other cases, an early stimulation is an induction.

When immediate breastfeeding is artificial - as a result of the fear put on
women that if their baby does no suck immediately, it is a bad sign or it
deprives her of the best for her health - I consider it as a "Hypothesis",
something "experts" in birthing think they have the right to impose on
women.  This induction is similar to all interventions which accompany
classical obstetrical deliveries.  In this case, the mother will take
advantage of the sucking reflex and convince her baby to take colostrum,
with such a "loving care" (produced by anxiety) that most babies would not
resist.  Hunger comes by eating, indeed, but a compulsive eating behaviour
might as well originate in the over-feeding of infants...  Parents and
attendants are in paradise: their baby is taking breast, the last step of
the delivery has been passed successfully, let us take snapshots showing
the "healthy" mother and child!   In such a conditioning, it becomes true
that if the baby does not respond it usually points at a health problem.

3- It helps for the meconium to be evacuated.

I never heard of any healthy baby not having pushed away her meconium one
day or the other, even if she fasts.

Let us consider the case when the colostrum is expelled immediately after
birth.

The colostrum has depurative properties.  As soon as it reaches the baby's
intestines, it evacuates the meconium, and, doing so, the colostrum is
evacuated as well.

We are left with an intestine cleaned earlier but unable to benefit fully
from the colostrum.

When we leave time for nature to work, the colostrum comes after two or
three days, which is the time usually required for the meconium to be
spontaneously pushed out.  The baby becomes hungry because her intestines
are clean and her hunger is met immediately with this highly rich food
which reinforces her digestive (and immune) systems ready to receive and
benefit from it.

4- No risk of harm from foreign element.

It is true that the mother's milk is the best for the baby, and that a
feeding with foreign food is either inferior in quality (processed milk),
or dangerous (indigestible).

Still, doctors are fearing a priori haemorrhage for the new-born who cannot
process vitamin K until a foreign element comes to her intestines.  So they
currently provide the new-born with synthesised vitamin K.

When a baby fasts spontaneously for one, two or three days, till her
meconium comes out, she gets thirsty.  When you give a few spoons of water
with drops of lemon, honey or milk as most Indian rural women do, you
provide her with a small quantity of foreign food carrying microbes to the
intestines, which in turn induce the vitamin K that will protect the baby
against any haemorrhage incident.

The big argument opposed to that simple fact is that "mother nature"
provides for everything, and since her mother has colostrum and milk, these
are the only food the baby should take.

I agree that the transition for the baby from the womb to the outer world
should be as smooth as possible.  So, I took care that my son be born in
semi-darkness, in a quiet place with soft sounds to his ears and nobody
around save his mother and father.  He was handled in a rhythm and manner
adapted to him.  In the same way, I gave him this little bit of water to
help his organism to adapt smoothly and in the best conditions to this
world.

Nobody would protect her baby's nervous system by withdrawing any external
input.  The same is to be considered with her digestive system.

5- Stimulation of the mother's nipples, which in turn facilitates the
expulsion of the placenta, the contraction of the uterus (so important for
so many reasons), the flow of colostrum and milk.

It is very well known to the supporters of "natural" delivery that the
placenta detaches spontaneously in its own time (sometimes as long as 24
hours) when the delivery has happened in a way which respects the mother's
needs and instinct, and when no medical intervention has taken place for
the birth (see <http://perso.wanadoo.fr/bel/birth/clara.htm#discussion>).
The early stimulation of the nipples is relevant as a remedy to traumatic
states only.

The same happens with the necessary contraction of the uterus.  A woman
able to give birth to a baby and to the placenta without drug or technology
has her uterus contracting normally.  Early stimulation via the nipples is
required only for those cases which have turned "medical".

Colostrum and milk come as well automatically when no external pressure
interferes.  In any case, the spontaneous stimulation of the nipples when
the baby is hungry and sucks by himself completes the contraction of the
uterus and induces the flow of breast fluids in due time.

6- It allows or facilitates the bonding between mother and child.

Both WHO and supporters of birth as a physiological event advocate
immediate breastfeeding as the best way of establishing a bonding between
mother and child.  However, premature breastfeeding appears as an
intervention - indeed a necessary one if it is preceded with traumatic
birth.  It is otherwise possible to combine a natural ("delayed")
breastfeeding and a harmonious, complete bonding between the mother and her
newborn, even in case the baby needs to be bottlefed for medical reasons.

Breastfeeding should be allowed to happen at the moment the baby asks for
it, without us deciding for her.  Many factors during the delivery, but
also during the pregnancy and even before, along the mother's history, will
determine the baby's way of feeding.  It seems that what matters is not to
breastfeed sooner or later, but to feel the "right time" for each
individual.

When it is not needed to balance traumatic situations, the bonding between
mother and child does not require immediate breastfeeding.  It requires
mutual comprehension and attention, for love to blossom.

Andreine Bel <[log in to unmask]>



Cindy Curtis,RN,IBCLC
mailto:[log in to unmask]
http://www.erols.com/cindyrn

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