To breastfeed or not!
Immediately after birth, when parents hold this fragile little being in their arms for the first time, feelings of happiness predominate. But fear, sadness and insecurity can also be felt. Am I looking after my child properly? How am I going to change this little bundle of joy? What if I can't breastfeed properly? Find out how one couple, Fabienne and Peter, deal with this situation.
Norina Wartmann, an independent midwife, accompanied Fabienne and Peter during their pregnancy and birth. Since then, their first child has been born and they are now getting to know each other - a very beautiful phase that plays an essential role in the life of a family. They will soon notice that breastfeeding influences this period and strengthens the parent-child bond.
The story of Fabienne and Peter: [[marketingpage:4389]] [[marketingpage:4514]] [[marketingpage:4783]]
The topic of breastfeeding had already been discussed during the birth preparation course that Fabienne and Peter had attended. There, the midwife had talked about the benefits of breast milk: it's always available, it's always at the right temperature and it's free. With every feed, it provides the baby with precious vitamins, minerals, growth hormones, antibodies and much more. Breast milk contains a large number of things that enable a newborn baby to start life in good health. The midwife also said that breastfeeding didn't always work from the start. Fabienne's friends had already told her that breastfeeding wasn't always so easy and that it could even hurt. During a conversation with the midwife, Fabienne expressed her uncertainty. They talked about the couple's fears and Norina gave them the contact details of a friend of hers, a breastfeeding consultant. And that's where I come in - Chantal Häusler - independent breastfeeding consultant IBCLC*.
Some couples already contact me before giving birth and ask me questions about breastfeeding. In all cases, it's best to get information from a breastfeeding consultant beforehand. After the birth, you've got other things on your mind. So it's a good idea to have the number to hand.
To breastfeed or not to breastfeed?
There are many reasons why women choose not to breastfeed. Often, they have had bad experiences with their first child, have received poor or insufficient advice, or don't want to ask too much of their body. In fact, physiologically speaking, only one or two per cent of women are unable to breastfeed. Nowadays, I often find that families are overwhelmed by their new life with a newborn baby. There is little or no support and no 'role models'. This often causes stress. The stress hormone cortisol is a typical 'breast milk killer'. The production and flow of milk is severely disrupted by stress. This means that the baby does not get enough breast milk. The breastfeeding couple quickly ends up in a vicious circle, from which it is very difficult to escape without outside help. From a medical point of view, there are rarely any reasons why a woman should not breastfeed. There are various "breastfeeding-friendly" medicines and measures, such as breastfeeding teas that stimulate milk secretion.
Parents also sometimes decide to bottle-feed their child. The child may also have to take a bottle in addition to breastfeeding because, for the reasons given above, breast milk is not enough. Initially, you should opt for a bottle with a small hole in the teat - the baby needs to use and train the muscles around the mouth. This is very important for later language development, for example.
And suddenly, we're parents
Fabienne is still feeling weak and tired after the long labour and the surgery she underwent to remove the remains of the placenta. She is happy that Peter is sleeping in a family room with her and looking after the baby - who is called Benjamin. The three of them have just spent their first night together. No one has slept much. The hospital staff had to check Fabienne's condition regularly and measure her vital signs. Barely back to sleep, Benjamin lets everyone know he's hungry.
The maternity nurses help Fabienne with body care and show Peter how to change Benjamin's nappy. Fabienne finds it difficult to stand for too long. A little wistfully, she watches as Peter changes little Benjamin's nappy with ever-safer movements. Fabienne has not yet managed to breastfeed without help. The nurses and Peter help Benjamin take the nipple into his mouth. If that doesn't work, Benjamin cries. With a lot of patience and help, he manages to latch on and eats his fill. The feeds are getting closer and closer together.
During the second night, Peter and Benjamin were seen several times in the hospital corridor. To give his wife a chance to get some rest, he wanders down the corridor and tries to get the little one to sleep. From time to time he brings him back to the room so that Fabienne can breastfeed.
In the flow of emotions or when hormones rule
"Putting him to the breast is starting to hurt! I'm already dreading the next feed. Is this normal? I'd thought it would be completely different. Every nurse gives me different advice. I'm a bit lost and really tired," Fabienne tells me over the phone. She called me because she started to wonder about breastfeeding. "I can't even look after Benjamin, because I can't stand up for long. It makes me sad. And to breastfeed, I need help too. I'm no good at anything. I don't even know if I'm really lactating..." There's a long silence, then a quiet sob. At times like these, I often think, as a breastfeeding consultant and mother: "Welcome to the mums' club". I calm Fabienne down and explain that she needs to give free rein to her feelings and that she has the right to cry too.
"Now I'll explain to you why you really need to let someone help you put the little one to the breast: before, your nipples were of no use to you and now we need them 100%. They're under a lot of pressure now, and you have to get used to them. If, on top of that, the baby isn't suckling properly, for example if he doesn't latch on enough, this can cause extra rubbing and irritate the nipples, which is very painful."
Lactating when needed - demand controls supply
Breastfeeding when you need it allows you to stimulate your breasts sufficiently and produce enough breast milk. But what is meant by "breastfeeding when needed"? A child "needs" the breast in many situations. Firstly, to calm hunger. Secondly, taking the breast helps them to fall asleep, to cuddle, to process new impressions or to calm down. For this reason, it is not advisable to use anything else, such as a dummy, or to use it only specifically and briefly after breastfeeding. The great advantage of breastfeeding as and when you need it is that you don't have to wonder why your baby is crying or unhappy. All you have to do is put him to the breast and that's it. You don't need a watch either. It doesn't matter whether your baby was last breastfed three hours ago or 15 minutes ago. You can't do anything wrong. The older your baby gets, the more strategies he'll develop to calm down. Some babies do this very quickly and others need more time. In simple terms, the more often and for longer you breastfeed your baby, the more breast milk your body produces.
"Next time you're breastfeeding, look to see if you can hear Benjamin swallowing. If you hear it, he's drinking milk. Sometimes it sounds like a little click. I'm glad Peter's helping you like this. Make the most of it, you'll soon be able to change and carry Benjamin too. If you breastfeed him often, you'll also have some wonderful moments together. You can call me any time, don't hesitate. If you have any questions, I'm here to answer them."
We say goodbye and Fabienne tells me that it's been good for her to talk to me.
Not the "right" environment
Because we no longer live in large families these days, children no longer grow up in a sort of tribe. Mothers often can't imagine what it means to live with a newborn. Being available 24 hours a day, day and night. During the postnatal period, which lasts six to eight weeks, mother and child are supposed to be able to relax and let themselves be pampered. The days in hospital are short and, unfortunately, many fathers have to go back to work after giving birth - they don't have time to rest. The brand-new family usually has few opportunities for support, with parents and in-laws living further away or even abroad. The mother now finds herself alone with a newborn baby, delivered without instructions. And maybe she'll even be going back to work soon. The first few days are synonymous with a whole new life. It's not just the physical changes that take place in the mother. Psychologically, too, the young mum and dad are on a rollercoaster ride. Uncertainties, sadness and fears often mingle with joy, relief and happiness.
Home sweet home - what now?
Barely home, Fabienne calls me: "Benjamin is now five days old and we're allowed to go home tomorrow. During the day, I breastfeed as soon as he cries out and, at night, he wants to drink once or twice. The nipples are much less painful. But I'm a bit worried about Benjamin's weight. At the hospital, they told me that he'd lost weight and that he wasn't allowed to lose any more. Otherwise, I'll have to give him something extra. Norina is coming to visit us tomorrow and she's taking the scales with her. What else can I do and what milk powder should I give him if I ever need to?"
I think that because of all the blood she's lost, Fabienne needs time and especially stimulation to get the amount of milk she needs. "It's great, you see, you're already a good team and you're on the right track. It's important that Benjamin sleeps next to you at home, in the same room. Ideally, he should drink at least once more during the night. Otherwise, feed him as soon as he's hungry. You'll see, at home, in your usual environment, you'll feel better and you'll be able to produce more milk. If you really don't have enough, you can also exceptionally give him PRE powdered milk. This is the type of milk whose composition most closely resembles that of breast milk. I'll come and visit you at home in a couple of days and we'll see what we do then."
This damned weight issue
In the first few days of life, newborn babies generally lose weight. They can lose up to 10% of their birth weight and then gain it back. After about two weeks, they should weigh the same as they did at birth. Babies are often given powdered milk too quickly, which leads to less frequent and shorter feeds. As a result, the breast is less stimulated to produce milk.
I'm standing in front of Peter and Fabienne's front door. My bag is full of breastfeeding aids, documents, leaflets and a breast pump. In the car I also have a laser, which would be used if Fabienne had sore nipples. Laser therapy promotes blood circulation and speeds up the healing process. I secretly hope I won't need all these things. The flat is chaos. But other things are more important now, the housework can wait. Fabienne is lying in bed, nursing Benjamin. "Hi Chantal, I'm glad you've come. I sit down next to her and confirm that everything's fine. I hear Benjamin swallowing regularly and I'm relieved. "Fabienne, it's working really well! Benjamin is now getting a good quantity of milk, it's fantastic!" The milk flows from the second nipple and runs down Benjamin's nose. He doesn't seem to mind. "How do I know when there's no more milk?" asks Fabienne. "You just have to watch Benjamin. As long as you hear him swallowing, there's milk. Sometimes you need an intermediate phase during which the baby sucks just to try and trigger the next ejection reflex. But if he sucks for too long, if he starts to get impatient and if he's still hungry, you can switch him to the other side. You can also change sides during a feed, as most breast milk is produced during breastfeeding."
After breastfeeding, we put Benjamin on the scales and, like yesterday, he gained 40 grams. With a newborn, the important thing is not how much weight he puts on, but that he puts on weight. I can assure the couple that they don't need any powdered milk for the time being. "Keep breastfeeding and relax. You're doing great. Call me if you have any questions. "It's with a clear conscience that I say goodbye to the couple.
In a future article, you'll find out what a milk pump is used for and how Fabienne gets over breast engorgement.
IBCLC stands for "International Board Certified Lactation Consultant". These lactation consultants have medical training and have passed their exam on the subject of breastfeeding. Three breastfeeding consultations with an IBCLC consultant may be covered by basic health insurance. There are also LLL breastfeeding consultants. They are trained by "La Leche League". The counsellors are themselves mothers who have breastfed their children. They are there to share their own experience of breastfeeding and give mother-to-mother advice. LLL breastfeeding meetings are held regularly in all the regions. These give women the opportunity to talk to each other, make new friends and get detailed information.
I am married and mother of two sons. As a trained nurse HF, I worked in the maternity ward of the Stans hospital and in the Lachen hospital as head of the nursing outpatient clinic.
After my further training as a lactation consultant IBCLC and as a "sleep consultant 1001kindernacht" I am currently a freelance lactation consultant IBCLC in the canton of Zug and run my own practice in Unterägeri. I am also president of the board of the association kindLine, which runs the unique family centre in the canton of Zug.<br><a href="http://stillberatung-haeusler.ch/" target="_blank">www.stillberatung-haeusler.ch</a>