Spinning the thread – how we learn to feed our babies

At a conference, in 2005, I met Dr Christina Smillie, a paediatrician and lactation consultant from Connecticut. She introduced me to the idea that, given time and support, babies can latch themselves. Of course, I had seen Richard and Alade’s video from 1990 – Delivery Self-Attachment – but I had never seen anyone allow a baby to self-attach. And I had no idea a baby could do it weeks, even months after birth. I was so excited! I had to find a parent-baby and try this out! I went home, and I started trying Baby-Led Latch with the parents who came to me for lactation support.  I was amazed. I came home after consults and gushed to my family about how clever the babies are and how happy and relieved the parents were. When we let the baby lead the way, the baby often latches on better and more easily, with much more comfort for the mom.

About five years later I read an article in the Journal of Human Development by Dr Suzanne Colson, a British Midwife, about how putting the parent in a reclined position and putting the baby tummy down, on top of the parent, releases reflexes which allow the baby to find the breast and latch on most effectively. Dr Colson (she has a PhD in Midwifery, which is why we call her Dr Colson) explained in detail what Dr Smiley had discovered by trial and error. The parent’s body is the baby’s natural habitat, and in that context, tummy-down, the baby is able to use head-bobbing, rooting, reaching and grasping, stepping and placing reflexes to find the breast and latch on! So I started to show my clients a more reclined position for nursing their babies. And everyone, including the babies, breathed a sigh of relief!  The parents relaxed, they stopped craning their neck and hunching their shoulders, they were able to rest while nursing and their milk flowed better. The babies responded to their parents’ mood and relaxed too. They were able to latch on very deeply, because their heads were free to move and their mouths could open really wide. By latching on deeply, they stimulated the breast better and removed more milk, thus helping the breast to make more milk.  If there was already a lot of milk and it flowed very fast (as it does for many moms) the baby dealt better with the flow when lying on top of the moms as the milk was flowing uphill.  

Some parents asked me if starting out this way was going to mean they had to lie back and undress the baby for every feed – forever!  No. As the baby gets older and the parent-baby pair gets more confident and competent, they can use all sorts of other positions – ones that involve mom sitting upright in what I call “Starbucks-friendly positions” – positions you can use in a coffee shop without attracting a lot of attention. There is a whole world of breast/chestfeeding positions out there, and they are different for each parent-baby, and different for every stage of their lactation career.

Baby-led Latch and Laid-Back Breastfeeding or Reclined Breastfeeding (or Biological Nurturing, the term Dr. Colson has trademarked) have become the core of my lactation teaching. These techniques can be done at birth, but also weeks later. They prevent lactation problems and solve them too. They help tired parents get more rest and hungry babies get more food.

But I started to wonder, why did I spend over ten years teaching women to sit upright and hold their baby’s head and control the latching? Where did we get the idea that this was how babies had to feed?

In books giving advice to parents – as far back as the beginning of the 1900’s – recommend sitting up to breastfeed, with a “flat lap” and holding the baby to the breast with firm pressure on the upper back. Alternatively, the parent could lie on her side, again holding the baby close with pressure on the baby’s back. This was because babies were believed to prefer feeding on their backs. Albrecht Peiper, a German paediatrician, described the human infant as an “obligate dorsal feeder”, unlike other mammalian infants – cats, dogs, rabbits – who naturally feed while lying on their bellies and are described as “ventral feeders.”  Where did we get this idea?

Now I have to give a warning here. None of what I am going to say next has been proven. It is my hunch. Maybe someday, I will have the time to go and prove it to be true. But as a hunch, I think it is worth thinking about. It helps us to think about how knowledge is gained and lost, and then regained.

Two or three hundred years ago, in Europe and among Europeans in North America (a whole other story, about which I know very little, was going on among Indigenous People) parents gave birth at home, assisted by midwives who were most often mothers themselves. If there was no trained or experienced midwife available, there was likely some older woman who had seen other babies being born or had given birth herself. The new parent was encouraged to stay in bed and rest and recover for several days, if not a few weeks – the “confinement” or “lying-in.” Now of course this only applied to women who had families for support (and homes), but that was still a large majority of the child-bearing women.

So the parent kept to her bed. Remember these were not firm, springy, modern mattresses – they were soft and squishy and made of straw or hay, with a layer of feather over the top, if you could afford it. And the fashion in the 1700’s and 1800’s was to lie on pillows, semi-reclined – not flat as we do today. (That’s why when you see those old beds in museums, they look so short. Yes people were shorter back then, but not that much.) So the new parent, reclining on her bed of straw and feathers would have held her baby on her chest and she would have had lots of time to learn, and her midwife would have observed, that the baby was most comfortable nursing that way. Later, when the parent was up and out of bed and back to their work, they would have fed the baby as they sat up on a bench or a chair. But remember, older babies can feed in all sorts of positions.

Around 1900, in urban areas, and the middle of the century in the countryside, women started to use the hospital to have their babies. There, they were cared for by doctors (mostly male) and nurses or nurse-midwives (who were unmarried and not mothers themselves.) These care-providers had never seen the parent-baby pair in their “natural habitat” – the parent on a soft bed of natural fibres and the baby on the parent’s soft body. Where had the doctors and nurses of the early 20th century learned about breastfeeding? In hospitals where sitting upright on the firm, tightly-made beds was possible? In a society where sitting up straight was a symbol of moral rectitude? In medical and nursing schools where “good posture” was considered part of good health? Probably.

But I would also like to suggest that some of the images of breastfeeding these doctors and nurses had in mind were paintings. There are many many European paintings of mothers nursing babies – a lot of them are paintings of Mary and Jesus. And almost all of those paintings depict a mother feeding an older baby. Why are they all of older babies? Because new mothers stayed in bed! They were not posing for paintings! So the pictures of breastfeeding that have been handed down through the European culture are of how we feed older babies. And the nurses and doctors of the 20th century tried to apply techniques suitable for older babies to newborns.

There has been a lot of discussion of why lactation is so difficult for new parents nowadays. Why is it so difficult for us to provide parents with enough good lactation support so that they can not only initiate lactation, but also continue to feed their babies at the breast/chest for the two years (or more) that are recommended by World Health Organization. Is it because parents-to-be have not usually had the opportunity to witness other parents feed their babies from their bodies? Is it because the grandparents of today often did not breastfeed themselves? Is it because our culture has lost our breastfeeding/lactation heritage?

Yes. When the process of birthing and recovering and learning to breastfeed and care for baby moved into the hospital, we lost the thread to past generations of lactating parents and grandparents.

When I help a parent get comfy in bed with many pillows behind her, when they place their  baby on their chest, and I watch that baby head-lift and look up at the parent’s face, when I see the parent smile in response to the baby’s gaze and rub the baby’s back, and I see the baby start to bob on the way down to the nipple, I know that we are spinning the thread that will link this parent to their baby and to all the babies beyond.

For more about the Laid-Back Breastfeeding Revolution see https://www.midwiferytoday.com/mt-articles/biological-nurturing/