I teach a big breastfeeding classes at a large hospital, a free add-on
to the childbirth series. So the audience is a real mix -- some seem
passionate about the idea, others in the "well, maybe I'll try"
category. But that latter category needs us more.
I do play up *why,* since the parents' other healthcare providers may
be noncommittal on this. The talk leans heavily on Diane Weissinger's
approach of breastfeeding as "normal" and species-specific -- that if
someone says, "Oh breastfed babies are. (fill in the blank)..." that
it's just like saying "Oh, babies who were fed by placenta are...."
My class aims at getting everyone "over the hump" of the first 2-3 weeks
-- if someone can nurse for 6 weeks, six months is a cakewalk. It's
vital to convey how different the first few establishing weeks are from
all that follows. So many people give up in that first week, saying "I
can't do this for a year." It's a transitional time -- you couldn't
maintain the pace of a honeymoon's activity level for the years of
marriage that plod along (that can get a laugh).
Because we tend to judge breastfeeding success by how much we can make
it like bottle-feeding, the clustered or frequent feeding makes people
panic that they don't have enough milk. So share ways to tell the baby
is ok,. Help them see that their baby is sooo smart, and is trying to
send a message and kick-start the supply-and-demand system by feeding
frequently -- your body never wants to waste anything, and so it has to
get this message.. And how much comfort that little overwhelmed baby
finds in cozy sucking. That the colostrum is there in small concentrated
amounts, and the number of feedings is important to keep the baby
stable. And that the more they are feeding across the early days the
sooner and more smoothly the milk can transition to larger volumes, with
less chance of getting uncomfortably engorged. And why to wake a sleepy
baby
I don't think you can say this enough. People aren't bursting with milk
the minute the baby is born, so they don't feel the urgency to keep this
baby skin-to-skin and feeding frequently (especially in a busy hospital
or just-home environment with lots of visitors and everyone telling the
mother to "rest."). So once the weight is down or the jaundice numbers
are up, then there's a panic.
I also try to make people feel that they have some resources for help.
We have to combat the idea that breastfeeding either works immediately
or that's the end of the story. ("Oh well, you tried.") That in our
current healthcare system, they may have to actively seek out the help
they need. People must have hope that they can solve any problems that
come up. I also try to convey that first rule is that we "feed the
baby" since people are afraid they will endanger their baby if they try
to work on breastfeeding.
I used to finish the class with pumps and back-to-work issues, but found
that to be a bad ending note. So right after the break, I spend about
15-20 minutes talking about pumps, storage, back to work issues, and
give some resources for more information, including the IBCLC-moderated
mother's group at the hospital. I stress being in moment with the early
weeks, because getting a great supply established and a baby who loves
to breastfeed are great for all the transitions ahead.
Now I finish the class with getting comfortable with positioning and
latching, talking in more general principles, with an emphasis on the
baby as an active dance partner.
The class includes several videos, including one without narration that
plays while people are coming in and getting settled, since a lot of
people have never seen this activity before.
"Breastfeeding Made Simple" by Mohrbacher and Kendall-Tackett is a great
prenatal book to recommend or to steal from for a class.
Margaret Wills, LLLL, IBCLC
Maryland
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