Your Breast Fed Baby Isn’t Starving – But How Do You Ditch The Doubts?
It seems as though there is almost a campaign of scare-mongering against breastfeeding.
Recently, there has been a barrage of reports on social media of breastfed babies being ‘starved’. While my heart goes out to any parents who have lost a baby, I find it even sadder that the parents will bear the burden of guilt that they could have starved their baby.
No parents will willingly deprive their baby of food. All parents with concerns about their baby’s health deserve to have these concerns taken seriously: it may be your first baby but you are still the expert about your baby. If you are worried, please don’t hesitate to seek medical advice. If you aren’t reassured, please persist or find another practitioner to assess your baby. Trust yourself.
These reports of ‘starving’ breastfed babies make great media headlines but they undermine the confidence of new parents. Health professionals and self acclaimed ‘baby experts’ who jump on the ‘starving baby’ bandwagon and advise formula supplements ‘until your milk comes in’ further undermine women who want to breastfeed as they worry, do I have enough milk? Should I give my baby formula as well? Could my baby be starving?
Factors that may influence milk supply
Of course there can be factors that may create challenges to a robust milk supply – from baby issues such as poor latch, ineffective sucking, tongue tie, low oral muscle tone, to maternal medical conditions such as breast surgery, retained placenta, postpartum haemorrhage, PCOS, Diabetes, Thyroid conditions and insufficient glandular tissue (IGT) or lifestyle issues such as alcohol and smoking or birth control pills. However, in my experience as an IBCLC lactation consultant, women are being let down by a lack of support and inappropriate advice. With appropriate support as early as possible, almost all of these issues can be addressed so breastfeeding can continue.
“Starving baby’ cases – what could be happening?
Firstly, let’s look at one of these cases: a father reports that his newborn lost thirty percent of his body weight in four days. For a very average 3 kilogram newborn this would mean the baby had lost at least a kilogram. If this was even possible, it would mean an extremely unwell baby, likely dangerously low blood sugar levels and jaundice if this was during the first few days. Also note, a baby who wasn’t getting milk for 4 days would not be passing urine or bowel motions. This baby would need to be urgently evaluated before four days had passed.
When the mother of this baby tried to pump milk, she didn’t get any, so these poor parents were led to believe they must have been starving their baby. I can only imagine the guilt and fear this could cause and I can certainly understand why they would reach for the bottle.
The thing is, under extreme stress, pumping would not be an indicator of milk supply. For starters, the mother’s stress hormones would almost certainly inhibit her letdown reflex, causing further stress as her milk failed to flow. Even women with a healthy milk supply can find pumping difficult and an effectively feeding baby will almost always extract more milk than even a good quality breast pump.
This case begs the questions: was the baby weighed on different scales (not all scales are calibrated the same so inaccurate weights can often be reported between hospital scales and those of visiting midwives and scales at the child health clinic)? What sort of support and information were these parents getting from their health care professionals? And why weren’t parents educated to note the baby’s output (wet and dirty nappies) and to understand whether baby was transferring milk (swallowing as he fed).
Another extremely sad report of a mother whose baby had not regained birth weight by one month shows a photo of this clearly non -thriving baby at a month old. Finally, after several health professionals had dismissed her concerns (which were completely justified), this mother was referred to a lactation clinic. However, this was too little, too late. The incredible stress of a regime of expressing and feeding, exhaustion and worry about her baby’s well-being, along with the grief of her father dying two weeks before her baby was born was overwhelming. Despite this mother’s commitment to breast-feeding , her breastfeeding journey came to an end. Thankfully her baby is now thriving.
Fed is best is unhelpful
The problem with these sensational media reports is that breastfeeding gets the blame. Not the health services that have let these families down. Not the formula companies who undermine women’s confidence as they blatantly advertise their product with fancy billboards, clever TV commercials and free samples on pharmacy and medical centre front counters. Not the movement of ‘fed is best’ that is an insult to any mother who is struggling to breastfeed. Too often the line “fed is best” is fed to women struggling to breastfeed when the helpers don’t know how to help. It’s a lame way for helpers to get themselves off the hook. It isn’t helpful to women who are trying their best to breastfeed and are seeking help. And it isn’t helpful to a mother grieving the loss of a breastfeeding relationship when she has tried so hard to breastfeed through insurmountable challenges.
Rule number one – FEED THE BABY!
Always, always, the first rule is ‘feed the baby’. Sometimes this will mean the baby needs to be supplemented with either safely screened donor milk or formula. But equally important are the mother’s feelings, her well-being and the support and education she is given.
A new mother is vulnerable – she is completely responsible for nourishing and nurturing her little child as she climbs the learning curve of adjusting to this new role and responsibility of becoming a mother whilst dealing with a lack of sleep, fluctuating hormones and recovering from birthing her baby. The new mother is also getting to know her baby, dealing with a barrage of conflicting and confusing advice and, above all, wanting to do the best for her child. She needs support; she needs accurate information; and she needs carers who will listen to her concerns, not implications that breastfeeding is risky or trendy platitudes like ‘fed is best’.
So what can you do as a new parent or parent to be?
Educate yourself – learn about breastfeeding, preferably before you have a crying baby in your arms and doubt in your heart. Good resources include: ‘The Womanly Art of Breastfeeding’ (La Leche League); Breastfeeding Simply ebook and recording (Pinky McKay), the website www.kellymom.com .
You can also download our FREE ebook ‘Making More Mummy Milk,Naturally” by Pinky McKay HERE
Get Support – join The Australian Breastfeeding Association or La Leche League. Both organisations offer a wealth of information, free libraries and trained counsellors who will support you and refer to appropriate help if you have problems that are beyond their expertise. The Australian Breastfeeding Association offers a 24hour helpline.
Watch your baby – Can you see and hear your baby swallowing as he feeds?
Watch your baby’s chin as he sucks – just as you stretch your chin down as you suck up liquid from a straw, your baby’s chin will stretch down as he sucks in milk – the deeper the stretch the bigger the mouthful he is taking.
Is baby having at least 5 heavy wet nappies each day? Is he doing yellow bowel motions at least 3 times a day in the first 4 weeks (after this bowel motions may not be every day)? Remember, what comes out must have gone in.
Is your baby gaining weight? Your baby needs to be weighed on the same scales with the same clothing, preferably naked –there can be a wide variation between the hospital scales and the visiting nurse scales then the clinic scales.
It is normal for a baby to lose 5% to 7% weight in the first few days (some of this weight loss can be from IV fluids during labour), but 10% or more needs to be evaluated. Your baby should have started gaining weight by day 5 and regain birthweight between 10 days to 2 weeks if there are no health issues such as prematurity or a large early weight loss (be guided by your health carers). For more information about baby weight gains see HERE
See a Lactation consultant – International Board Certified Lactation Consultants (ask if she is an IBCLC) are allied health professionals with specialist knowledge of breastfeeding. They have thousands of documented hours helping mothers breastfeed, have to pass an intensive exam and re-certify every five years. An IBCLC will be able to observe and assess your baby feeding, take a medical history and address breastfeeding problems with referrals if necessary. Please see a lactation consultant as soon as you have concerns – before you are crying more than your baby. Often some simple adjustments can make a huge difference almost immediately – I have had mums say to me , “wow that doesn’t hurt any more”. Or “that is so easy, why didn’t anyone explain that.Patric