One of the myths surrounding breastfeeding is that moms needs to perform the act of milk production. Locked into the word ‘perform’, lies the minefield. Breastfeeding is not just up to the mom. Nature shows us that breastfeeding requires teamwork between the mom and her baby.
This article is written from a neurodevelopmental perspective where feeding is deemed the first motor milestone, and motor milestones are nature’s way of indicating brain development. Any difficulty with breastfeeding automatically questions the effectiveness of the baby’s sensory-motor system that underpins their brain development. Because breastfeeding requires skin-to-skin interaction between a mom and her baby, if either the mom or the baby has any sensory difficulties, breastfeeding could be compromised.
This article focuses on a baby’s sensory-motor system.
Firstly the baby needs to be ready to feed. Hunger plays an important part in the readiness to breastfeed, but the baby also needs to delight in touch to be ready to feed. Breastfeeding is ‘up close and personal’ and when a mom leans back and reads her baby she will easily see if her baby seeks touch or avoids touch. This is an important cue to notice.
When a baby seeks touch:
This is the cue that baby is calm, and ready to connect, latch, suckle and digest.
A cuddling baby is nature’s way of communicating that a baby is ready for successful feeding. When the parasympathetic nervous system signals readiness, the feeding-trio: suck-swallow-breathe, co-ordinates rhythmically and breastfeeding becomes a natural consequence.
When a mom notices that her baby is:
Research at the BabyGym Institute in Johannesburg has found that when a baby pulls away from touch, and is not comforted when held and cuddled, the withdrawal reflex may still be active.
The withdrawal reflex sensitises a baby’s skin to create a map of his or her body in the brain. A body map is important to regulate sensory input (senses) and motor output (muscles). Nature uses the contractions during labour to:
When the withdrawal reflex stays active, the baby tends to feel overwhelmed and threatened by touch due to an immature body map and a hyper sensitive skin.
The skin is the oldest and largest sensory system in the body and supported by the sense of smell – the primal sources of comfort. When the skin shows signs of over-sensitivity to touch, it triggers the protective response of the sympathetic nervous system to prepare for a battle – fight, flee or freeze. When a baby’s skin is overly sensitive to touch due to a persistent withdrawal reflex, skin-to-skin contact may become a battlefield that tends to aggravate rather than comfort.
The solution is not to avoid life-affirming skin-to-skin contact, but to calm the sensory system and sympathetic response before skin-to-skin contact is introduced. Without the calm and relaxed support of the parasympathetic nervous system, breastfeeding can be a sensory battle.
As smell and touch are primal senses, a baby tends to find the mom’s natural body smell, when unmasked by perfume, comforting. A mom is encouraged to sleep on her baby’s blankets to transfer her comforting natural smell to the blanket. Research at the BabyGym Institute has found that the presence of a mom’s natural smell is a wonderful immune booster in the NICU (Neonatal Intensive Care Unit) when a blanket, soft wrapper or night shirt smelling like the mom is rolled to create a cocoon around the baby in an incubator. When the baby’s sense of smell senses that mom is close by, baby tends to be calmer and not in a constant state of fight and flight. This in turn, boosts immunity and may potentially shorten the hospital stay. Because the baby is calmer he or she also becomes more receptive to touch and feeding.
Deep pressure is nature’s way of inhibiting the withdrawal reflex, while activating the proprioceptors to regulate sensory input and motor output. When a baby avoids touch, a gentle but firm massage encourages the baby’s sympathetic system to go to rest, and proprioceptors in the skin to complete the body map. When a baby can localise touch due to a more mature body map, instead of being overwhelmed by touch, a baby can now start to seek touch and be comforted by touch.
The absence of anxiety, fidgeting, shallow breathing, rapid heartbeat, and hyper-sensitivity to touch are preconditions for successful breastfeeding.
Swaddling is an effective way of settling a baby just before feeding. Swaddling does not replace massage or skin-on-skin contact to develop a more effective sensory system. Swaddling is a short-term solution to feed a baby. Not all babies need swaddling. Only babies who need to be wrapped firmly to feel safe benefit from swaddling. Without the tightness of a reassuring, mom-scented wrapping blanket they feel anxious when skin-to-skin and their crying, fidgeting, rapid heartbeat and shallow breathing rate confirm that.
Avoiding touch, crying, fidgeting, a rapid heartbeat and shallow breathing is the perfect recipe for battling with breastfeeding, and seems to be one of the main culprits in gulping, reflux and colic.
Swaddling offers a short-term solution to feed the baby while daily massage over time settles the sensory system more permanently.
According to Dr. Michel Odent, a French obstetrician, the contractions around the crown of a baby’s head stimulates the sucking reflex. Once a baby is swaddled, with the hands close to its face and tummy to mommy, the mom may also want to cradle the crown of the baby’s head in the palm of her hand. When she holds her baby with one arm and rhythmically applies gentle pressure to the crown of the baby’s head with the other hand, it has shown to improve latching and rhythmic sucking.
When the mom is not massaging the crown of baby’s head, she can place the pad of her thumb in the palm of her baby’s hand. When she massages the palm rhythmically while the baby is suckling, it stimulates the Babkin reflex. This reflex opens the mouth in readiness to latch and encourages rhythmic suckling.
Reflex point therapists have added to our understanding of why a mom would instinctively massage the palms of her baby’s hands, one at a time. According to reflex point therapists there is not only a pressure point in the palm of a baby’s hand that stimulates suckling when the palm is massaged, there also seems to be a pressure point in the pad of mom’s thumb that stimulates the milk letting down reflex. The instinctive massaging of the palm of a baby’s hand seems to underline Dr. Odent’s statement that when the instinctive mommy brain leads the way, what is natural flows more spontaneously.
Successful breastfeeding does not need to be elusive. Breastfeeding is not only possible but also enjoyable when approached as team-work. It is our hope that a better understanding of baby’s sensory perspective adds to a more positive breastfeeding experience.