Milk
Breastfeeding: the bonding, the cuddles, the science
"So who thinks breastfeeding is going to be a walk in the park?" The lactation consultant scans the circle of a dozen or so very pregnant women (and one male partner).
"I'm not saying it can't be easy," she goes on eventually, after it's clear no one is going to raise their hand in response to this transparent victim hunt, "but it's better to beat your expectation than to be unprepared."
What follows is a two and a half hour lecture on how breastfeeding works, what to expect, and how to do it. It's free through the NHS: they gave me a a QR code to the Eventbrite page when I registered as pregnant with the public hospitals.
It's both helpful and intimidatingly presented. For example, the lactation consultants stress that any time you feed the baby with anything other than your very own nipples, you're messing up the feed supply—even if it's with breastmilk you've pumped.
"But what if I want to go out with my friends for a few hours?" The hijabi woman next to me asks. She admits, bravely, that she's worried about postnatal depression, given a November birth. I am, too. But while part of my plan is to whip a boob out in Victoria Park if I'm out walking and the baby's hungry, I suspect this is less of an option for her.
The businesses in Tower Hamlets, our borough of London, are apparently breastfeeding friendly. "That doesn't mean they'll give you a room," the consultant clarifies, "but they won't chuck you out."
As in so many aspects of pregnancy and childcare, a lot of unproven ideas are presented here as hard truths. I've read the Emily Oster chapter reviewing breastfeeding studies, watched the Happy Parents Happy Babies 45 minute lactation consultant lecture, and am now listening to four accredited NHS lactation specialists. Though there's much that these qualified sources agree on, all three also direcly conflict.
Here are the parts I'm pretty sure are true: that the baby's stomach starts out marble-sized, so it will need to feed very often over the first ten days while it stretches to something more like a ping pong ball. That babies are more active at night than in daytime, and that my prolactin—the hormone that brings in the milk—will be too. That my body will be highly reactive to the baby's feeds in terms of milk production.
There are some really cool parts: the nipple is porous and two-way; by absorbing baby's saliva, my body will alter the antibodies and nutritional content of the milk.
Everyone agrees that the latch, the way the baby connects with the breast, is super important. We watch a video that shows us how: a pointy, painful nipple means a shallow latch, where the baby is effectively trying to drink a thick milkshake through a straw. A proper, deep latch sucks most of the aureola into the baby's wide maw, where their jaw massages the milk ducts. This should leave the basically-swallowed nipple round, pores open: a showerhead at full stream.
So, we understand a lot of the mechanics. But there is a lot of other advice attached as well. For instance, the lactation consultant boldly asserts that the more you breastfeed a child, the smarter they will be. I know from Oster that despite numerous studies, there's no compelling evidence that this is true. The consultant also gives some iffy advice, extolling the virtues of self-expressing (along with a detailed demonstration on a knitted breast stuffy) to this roomful of women whose due dates all cluster within a week of mine.
"But doesn't self-expressing potentially bring on labor?" I ask aloud for the benefit of the group.
"Oh, yes," she admits. "You all probably shouldn't try this for a few more weeks."
We also learn that breast size is not an indicator of milk production, which leaves me frowning down at my overeager set: why, then? Why grow so much? Why do I have to carry this around?
Several weeks ago, I joined a Facebook group on breastfeeding in order to casually absorb anecdotal knowledge, and it now dominates my feed.
It's the perfect blend of supportive and salacious: women speculating on how their sex lives impact pumping outputs, pictures of milk that's come out pink or blue or proudly fat-plugged in the bottle. Frequently, there is some desparate post asking what to do with milk pumped after a wild night out. The consensus of the group is that "if you can find the baby, you can feed the baby"— that unless you're too drunk to have motor control, the booze is sufficiently dilute as to not harm a child.
Both of my UK sources, however, stress that you must not drink more than one or two servings of alcohol while breastfeeding. I don't remember where the evidence sits on this one. It doesn't seem like a major concern for me, or for most of the mothers in this NHS class; I'm one of only three not wearing a hijab. The most relevant advice I can remember is that you mustn't fall asleep while feeding the baby on the couch, to avoid accidental smothering.
Though breastfeeding a baby sounds like a lot of work, potentially quite hard, and full of contentious rules, I'm looking forward to it. I should have the time and interest to figure it out.
Breastfeeding is very, well, me. It's naturally produced; the science is fascinating; it's a unique experience; I might need to employ stubborn resilience. I'm curious how it feels and how it tastes. It lends itself to casual, slightly risque feminist activism. I don't need to bring anything extra if I'm going camping. And there's the gold star of social approbation we all like to pretend doesn't exist.
Here in the UK, it's very well supported. It's standard practice for the baby to be flopped upon the mother's chest immediately upon emergence, where the tiny creature can root around and figure the process out.
According to an NHS handout, the first 29-62 minutes of life are devoted to familiarization with the breasts, followed by a self-discovered first feed after 40-90 minutes earthside. Lactation consultants will be on hand in the delivery ward, and we'll get a home visit in the first week for further assistance.
There are also child and family centres (like the one where we're having this training).
"We have moms come in and just want to sleep on the floor," one of the consultants attempts to reassure. "We set up a little space for them. And we have lots of tissues. Sometimes people just need to cry for a while."
But, you know. It's magical.
I think it really will be: the bonding, the cuddles, the science. Immediate breastfeeding helps cue the placenta to deliver. Subsequent breastfeeding triggers the uterus to contract back down into the pelvis once the baby is out. Short term, breastfed baby should have fewer infections, nicer poops, less gas. Long term, it lowers my risk for a couple of cancer types. Assuming it works out.
There's not really any way to know how it will go in advance of the actual baby. But my bras are regularly picking up colostrum spots, and the milk ducts are definitely doing something that makes them warm, hard, and sore. So those are probably good signs.
I'm a little over 34 weeks now. When people ask when I'm due, I'm usually phrasing in terms of the bell curve: one to two months from now. The fetus will be full term in just under three weeks, but the likelihood peak is another three after that. Any way you put it, that feels soon.
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