Hi, Esther and Others:  I strongly feel that if we all gave birth in the manner 
that Mother Nature intended, we would all have milk by the end of the 1st 24 
hours. I feel that the 3-5 days for the milk to come in is an artificial parameter 
fostered by modern health care practices.  Mother Nature births can be 
described as totally unmedicated vaginal births with no outside intervention 
followed by baby moving from the vagina immediately to mom's bare chest, 
followed by a quick drying and warm covering while still on mom's chest.  
Babies who are born in this manner who are also left uninterrupted with mom 
for an hour or more will quickly do one or two or even three good feeds within 
the 1st few hours post-delivery.
Now, how is this accomplished within the typical hospital setting?  By 
promoting as much uninterrupted skin-to-skin care as possible for as long as 
possible.  It must be stressed that breastfeeding is HORMONE-DRIVEN in BOTH 
mom and baby and skin-to-skin promotes high hormone levels in both.  I 
believe (wish someone would research this) that the effects of a lot of the 
negative hospital birth practices on early breastfeeding can be diminished by 
promoting higher hormone levels in mom/baby thru lots of skin-to-skin.  I 
believe that lactation hormones help negate the effects of the hospital birth 
for both mom and baby.
I see this every day in my hospital practice - typical sleepy, uninterested baby 
on day 1 or 2.  Help mom/baby into a comfortable skin-to-skin (semi or 
completely reclining) position and, voila!, instant interest!  Some of the babies 
get quite dramatic in their efforts to get to the nipple.  Parents are certainly 
impressed!
The more hands-off LCs and staff are, the more successful and confident 
moms tend to be in their breastfeeding efforts.
It would behoove us to take a page from the nursing patterns of other higher 
order primates.  My 14 year-old daughter got some nice pictures of 2 gorilla 
couplets nursing their toddlers at the zoo during the summer.  We watched, 
wondering, as a gorilla grabbed a handful of straw from a large pile in the 
gorilla enclosure and ran up to a high ledge where it threw it down on the 
ledge, threw itself down on its back with its hands stacked behind its head 
pillowed on the straw, and with its legs propped up against a nearby wall.  A 
young gorilla promptly ran to the adult, threw itself down on the adult's chest 
and began nursing in what we humans call the Australian hold.  Only after 
the "baby" started nursing did we realize what all this preparation on the 
mama's part was for - NURSING!  And isn't recent research telling us that the 
most comfortable nursing position for human mothers is semi or completely 
reclined?  And that possibly the worst position is bolt upright in a chair?
Food for thought...


Pam Hirsch, BSN,RN,IBCLC
Clinical Lead, Lactation Services
Advocate Good Shepherd Hospital
Barrington, IL    USA

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