Breastfeeding is part of a continuum. 

–This post is part of our 10-year anniversary series “Breastfeeding is…”

Breastfeeding is part of a continuum.

It has been hypothesized that starting around nine weeks of fetal development, the pattern and sequence of intrauterine movements of the fetus seem to be a survival mechanism, which is implemented by the newborn’s patterns of movement during the first hour after birth  (described as the 9 stages)  when skin-to-skin with the mother to facilitate breastfeeding.

Photo credit United States Breastfeeding Committee

This very behavior refutes the idea that breastfeeding is “an adjunct to birth” as it is generally viewed in maternity care settings in America.

Not only are human babies hardwired to progress through 9 stages and self attach to the breast, mammalian bodies are hardwired to produce milk too.

Around 16 weeks of pregnancy, the body starts to prepare for breastfeeding. This phase, called Lactogenesis I is when colostrum begins to be created. During Lactogenesis II, the secretion of copious milk follows the hormonal shift triggered by birth and the placenta delivery. After this phase, milk production must be maintained through a supply-and-demand-like system. [Neville 2001]

Even before a pregnancy is achieved, individuals are being influenced by the infant feeding culture that surrounds them, consciously or subconsciously laying a foundation for how they feel about feeding their own babies.

Pat Hoddinott’s, et al study found that women who had seen successful breastfeeding regularly and perceived this as a positive experience were more likely to initiate breastfeeding.

Exposure to prenatal breastfeeding education also affects breastfeeding outcomes. Irene M. Rosen and colleagues found that women who attended prenatal breastfeeding classes had significantly increased breastfeeding at 6 months when compared to controls.

Photo by Luiza Brain

Mode of birth and birth experiences influence infant feeding too, for both members of the dyad.

A growing body of evidence shows that birth by cesarean section is associated with early breastfeeding cessation.

Intrapartum exposure to the drugs fentanyl and synOT is associated with altered newborn infant behavior, including suckling, while in skin-to-skin contact with mother during the first hour after birth. [Brimdyr, et al 2019]

What’s more, the authors of Intrapartum Administration of Synthetic Oxytocin and Downstream Effects on Breastfeeding: Elucidating Physiologic Pathways found “No positive relationships between the administration of synthetic oxytocin and breastfeeding.” They comment, “Practices that could diminish the nearly ubiquitous practice of inducing and accelerating labor with the use of synthetic oxytocin should be considered when evaluating interventions that affect breastfeeding outcomes.”

Photo by Olivia Anne Snyder on Unsplash

In Transdisciplinary breastfeeding support: Creating program and policy synergy across the reproductive continuum, author Miriam Labbok takes a detailed look at “the power and potential of synergy between and among organizations and individuals supporting breastfeeding, the mother-child dyad, and reproductive health to increase sustainable breastfeeding support.”

Labbok points out that a paradigm shift on the issues in the reproductive continuum – family planning, pregnancy and birthing and breastfeeding– is needed.

“These are issues that are intimately, biologically, gender linked in women’s lives, and yet ones that are generally divided up to be addressed by a variety of different professional disciplines,” Labbok begins.  “Despite the impact of child spacing on birthing success, of birthing practices on breastfeeding success, and of breastfeeding on child spacing, we are offered family planning services by a gynecologist, birth attendance by an obstetrician or midwife, and baby care by a pediatrician. Having these ‘silos’ of care, each with its own paradigm and priorities, may lead to conflicting messages, and hence, may undermine the search for mutuality in goals, and collaboration.”

One such initiative looking to deconstruct siloed care is the Baby-Friendly Hospital Initiative which includes standards and goals for birthing practices, for breastfeeding-friendly communities, and guidance for birth spacing, in addition to reconfirming the original Ten Steps to Successful Breastfeeding, in recognition that breastfeeding occurs along a continuum.

Source: United States Breastfeeding Committee

1,000 Days emphasizes how breastfeeding fits within the global picture as a crucial part of a whole.

In the U.S. context, the 1,000 Days initiative recognizes comprehensive health coverage, comprehensive guidelines on nutrition during pregnancy, lactation, and early childhood for women in the first 1,000 days, paid family  and medical leave policy for all workers, and investments to ensure parents and caregivers can access good nutrition as solutions to a well nation and a well world.

 

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As part of our celebration, we are giving away an online learning module with contact hours each week. Here’s how to enter into the drawings:

Email info@ourmilkyway.org with your name and “OMW is 10” in the subject line.

This week, in the body of the email, please share with us some or all of your birth stor(ies).

Subsequent weeks will have a different prompt in the blog post.

We will conduct a new drawing each week over the 10-week period.  Please email separately each week to be entered in the drawing. You may only win once. If your name is drawn, we will email a link with access to the learning module. The winner of the final week will score a grand finale swag bag.

Breastfeeding is collaborative.

–This post is part of our 10-year anniversary series “Breastfeeding is…”

Breastfeeding is collaborative.

A breastfeeding dyad is a beautiful, fascinating, complex organism. Mother and bab(ies) attend and respond to one another facilitating nourishment, the flow of hormones, immunity, learning and bonding, comfort, fun, an all-encompassing sensory experience that has generational impacts on social, emotional and physical health.

Photo by Luiza Braun

In this intimate depiction of a breastfeeding dyad, a world of collaborative intricacies occur: the undulation of baby’s tongue to help with milk removal, the contraction of myoepithelial cells thanks to oxytocin elicited by baby, the removal of milk to signal mother’s body to produce more, to name a few.

It’s clear that breastfeeding is so much more than “the healthiest feeding choice” nutritionally speaking. Take the following anecdotes for example.

Nikki Lee offers her commentary to this case report on infant botulism in an exclusively breastfed baby explaining how interactive feeding can save a baby’s life.

https://unsplash.com/@luizabraun

“One doesn’t have to ingest honey to contract botulism. Exclusively breastfed babies can get botulism. Some parts of the continental US have c.botulinum in the soil; construction stirs up the soil, and the germ floats in the air. The breastfeeding mother is the one to notice that the baby’s suck isn’t as strong. This is a reason that breastfed babies survive botulism, because they get diagnosed and treated sooner than bottle-fed babies.”

In this case, breastfeeding offered early detection of breast cancer in the mother because of her baby’s refusal to nurse from one side. This phenomenon is known as Goldsmith’s Sign.

To demonstrate the importance of  the relationship that breastfeeding affords, we might consider the implications of separation. Lee again offers insight on the implications of mother baby separation in this piece.

Zooming out to view breastfeeding less individualistically and instead as a global food security system, we must recognize the collaboration necessary to support the breastfeeding dyad and abandon the idea that breastfeeding is a solitary act, a “one-woman job”.

https://unsplash.com/@luizabraun

In Breastfeeding as a ‘Resilient’ Food Security System: Celebrating…. And Problematizing Women’s Resilience in the face of chronic deprivation as well as emergencies, Dr. Vandana Prasad, MBBS, MRCP (Ped) UK, MPH describes breastfeeding as “wholly community-based”. Dr. Prasad continues that breastfeeding is potentially universally accessible and sustainable because it  “depends wholly upon the status of time, energy, health, nutrition and general availability of women”. This achievement, breastfeeding as definitely universally accessible and sustainable,  would require collaborative efforts by “governments, decision-makers, development partners, professional bodies, academia, media, advocates, and other stakeholders” working together, as Dr. Tedros Adhanom Ghebreyesus writes.

In the U.S., WIC has created an interactive resource “to help reinforce the important role that family and friends play in supporting breastfeeding moms.” The resource invites WIC staff to “click through the prompts with parents, grandparents, and others discussing when and how to offer helpful support so that mom and baby continue to thrive.”

At an organizational level, the United States Breastfeeding Committee (USBC) uses a collective impact approach to manage multi-sectoral collaborations, working to protect, promote, and support breastfeeding and human milk feeding.

Source: United States Breastfeeding Committee.

Internationally, the Global Breastfeeding Collective calls on donors, policy makers and civil society to increase investment in breastfeeding worldwide.

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As part of our celebration, we are giving away an online learning module with contact hours each week. Here’s how to enter into the drawings:

Email info@ourmilkyway.org with your name and “OMW is 10” in the subject line.

This week, in the body of the email, tell us: Who is your s/hero in the field of maternal child health?

Subsequent weeks will have a different prompt in the blog post.

We will conduct a new drawing each week over the 10-week period.  Please email separately each week to be entered in the drawing. You may only win once. If your name is drawn, we will email a link with access to the learning module. The winner of the final week will score a grand finale swag bag.