The body prepares for breastfeeding during pregnancy. Breast tenderness and the appearance of Montgomery’s Glands (see picture) occur as the body lays down the foundation for milk-making in the months to come. Women may even experience leaking of colostrum, although this is not indicative of postpartum milk supply. The birth of the placenta is what triggers the body to produce milk.
These glands secrete an oily, antibacterial substance that protects the breasts from over-drying. It is therefore not recommended to use soap on the breasts; use water alone. It is also unnecessary to wash the breasts before nursing.
It is important to know that your baby’s due date is an estimate. It is based on a 28-day cycle in which the woman conceives on exactly day 14. This is an average, and not what every woman’s body does, and so the due date can be as much as 2 weeks over or under in approximation. When a baby is physically ready to be born, their lungs begin to secrete surfactant. When it reaches levels that are adequate for healthy survival, it is believed that it signals the woman’s body to begin labor. In the last 5 weeks of pregnancy, the baby’s brain hits an enormous growth spurt to prepare him or her for life outside mom’s body. This graphic from the March of Dimes shows the differences in brain size in a baby of 35 weeks gestational age versus 40 weeks, and lists only a few of the problems a baby born too early can have, such as breathing problems, feeding problems, jaundice, and temperature regulation. For these, and countless other reasons, AVOID AN INDUCTION unless medically indicated for your or baby’s health.
Babies that are born prematurely, have jaundice, or are medicated are likely to have a weaker suck and require more patience when nursing. Breast massage (rubbing from the chest wall toward the nipple all around the breast) and/or expressing a bit of milk onto the nipple may help to encourage a sleepier or weaker baby to nurse.
More on Labor Induction/Augmentation
Labor is generally induced using a synthetic form of the natural hormone, oxytocin.
Oxytocin is responsible for loving and nurturing behaviors in humans, as well as orgasms during sex. At the end of pregnancy, a rise in oxytocin begins labor contractions that grow in intensity and frequency until the birth of the baby. There is a rest between contractions, and endorphins as well as other hormones are released that send a woman into an inward trance, if she is uninterrupted. A gush of oxytocin at the birth expels the baby and causes the woman to be overcome with emotion and adoration for her new baby. It, with the expulsion of the placenta, signals the production of prolactin, one of the hormones involved in the milk-making process.
Pitocin is the synthetic version of oxytocin, used in hospitals to induce (or start) or augment (make contractions stronger) labor. Pitocin is effective in producing labor contractions, but does so without the balance of the other hormones in the body. These contractions are stronger and closer together than natural contractions. The intense pain from these contractions is often difficult to cope with and many women will then ask for epidural or other narcotic pain relief.
Medications given to the woman during labor, cross the placenta and also medicate the baby. Some of the side effects of these medications for the mother include difficulty breathing (the mother will be given oxygen), low blood pressure (which will require the mother lay on her left side to ensure the baby gets enough blood), and possible severe allergic reaction called anaphylaxis. Some of the side effects to the baby include a low fetal heart rate (the normal range is 110-160 beats per minute), difficulty breathing at birth (may require resuscitation), excessive sleepiness/lethargy, and a weak suck (leading to feeding difficulties-breast or bottle). A persistent low fetal heart rate often leads to an emergency cesarean delivery.
A woman that has a cesarean birth, especially an emergency cesarean, will be separated from her baby until both mother and baby are considered stable, and anesthesia has worn off in the mother. She may have a delay in the transitioning of her milk from colostrum to mature breastmilk. Not to forget it is major abdominal surgery.
No matter what your birth choices are, be well informed on your own before labor. Your birth experience will affect the beginning of your relationship with your baby. The birth of each child is a unique memory engraved into a mother’s mind for life. Make it YOUR best birth possible. A surgical or medicated birth will not harm your relationship with your child, but it can be more difficult in the beginning. Be armed with information and support!
When having a hospital birth and planning to breastfeed, it is crucial to inform the staff upon your arrival in the hospital. Ask the staff to avoid bottles and pacifiers with your baby. Some babies will develop a “nipple preference” (also called “nipple confusion,” but babies are smart, not confused!) with the faster, easier flow of the artificial bottle nipples. Also, the suck used with artificial nipples is vastly different from the suck used to breastfeed. There are babies who have no problem switching between both from early on, but it is best to err on the side of caution. If you must introduce a bottle or choose to give a pacifier, wait at least 4 weeks and for breastfeeding to be well established. Also let the staff know that you want to nurse your baby immediately after delivery as long as all is well. If you have a birth plan, make sure your wishes regarding infant feeding are outlined in it. Even with the birth plan, though, keep in mind that once you cross those hospital doors, you are no longer on your own terms.
To best ensure YOUR best birth, it is wise to hire a doula. A doula will meet with you prior to the birth of the baby to discuss your preferences and may even attend childbirth classes with you and your partner. During labor and birth, she is there to support the laboring couple and serves as a mediator between the hospital staff and the couple. Though she is well-trained in common and less common birthing practices, she is not a medical person, but a support person. She in no way replaces the father or partner. During the postpartum period, she is there to ensure breastfeeding starts well, and that the parent-infant triad is bonding well. She knows when to fade into the background and when encouragement is needed. Many women refuse to birth without a doula after experiencing a birth with one!
When planning who will be with you in the delivery room and the immediate postpartum, be careful to choose only those who are supportive of your birthing decisions and your decision to breastfeed. Those who always must share their negative experiences or awful stories they have heard have no place in the hospital with you.
Many women feel that if breastfeeding is a natural act, it should come easily, but this is often not the case. Although breastfeeding is the biologically normal way to feed our babies, most of us did not grow up watching women nurse their babies. Most women do not have a long line of women in the family they can turn to with questions regarding breastfeeding. It is because of this that “learning” to breastfeed takes time, patience, and an open heart and mind. Before you give birth, take the time to find the resources in your area: doulas, lactation consultants, La Leche League Leaders, lactation counselors, and breastfeeding peer counselors are all good fountains of support and information. Whether this is your first or 5th child, every birth is different. Every child and every breastfeeding relationship is different. With time, we also change, so make sure you know where to turn in case a concern should arise.
Next- Getting Breastfeeding Started: Birth and the First Week (stay tuned)
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