The womanly art of breastfeeding
I always thought that breastfeeding was child’s play, a natural act of motherhood which would come on cue as soon as my child was born. Far from it. Breastfeeding is an art, for both mother and child. It is an art that takes patience, practice, and sometimes pain. Once perfected, the art of nursing, when possible, has many nutritional and psychological benefits for the mother and her child that include and are not limited to – boosting the baby’s immunity, providing all nutrients and water needs for the child, and strengthening the bond between mother and child.
As a first time mother, I was determined to breastfeed my child until he was 2 years old, or when he was ready to wean off the breast. I made this conscious decision based on all the information and research that I had gathered throughout my pregnancy concerning the benefits of breastfeeding. However, this perception changed when the reality of nursing struck me hard within days of giving birth.
I quickly realized that things were not going according to plan when my son cried helplessly due to hunger and I couldn’t seem to produce any milk to meet his needs. I tried haplessly to get my nipple to his lips only for this to make him more exasperated. His cries during and after breastfeeding tore into my heart. I was failing him. I had no milk.
Based on my limited prior knowledge, I was doing the right procedure; skin-to-skin contact and positioning baby properly for effective suckling, taking the breast to his mouth (instead of bringing his head to my breast), but he was not getting much out of the breast. Earlier, I had been informed that the first few hours/days of breastfeeding only colostrum comes through and it is the most important milk for baby’s immunity. I painstakingly tried to pinch my nipple so that small droplets of milk could land on his tongue. This seemed to calm him down albeit for a second.
What they don’t tell you about breastfeeding
The midwives at the hospital in Nyeri, where I gave birth, were not very forthcoming with information, assistance and encouragement on breastfeeding. Arguably, they (midwives) were too few on duty vis-à-vis the numbers of mothers and newborn babies under their supervision. My calls for help were often directed to a Kenya Ministry of Health poster hanging on the cold blue ward wall, with vague instructions on how to properly nurse and latch the baby.
“Make sure the areola is in his mouth,” the midwife ordered.
“Which part is the areola?” I enquired rather sheepishly, baby brain in full effect. It’s not every day that the areola gets pointed out or given credit as a significant body part. It is there, visible to a woman everyday but more aesthetically than functional, well, until one gives birth.
“You mean to tell me that you don’t know which part of your breast is the areola!” she exclaimed, visibly irritated and impatient. “The areola is that big black area surrounding the nipple on your breast.” She remarked.
I looked at my areola. Sure I had seen it for as long as my breasts had started to grow out of my chest. I looked at my small fragile newborn baby, his mouth pouted in anticipation ready to suckle. My gaze flickered – unsure, blank, novice – back to the midwife who was expecting me to take her words as a cue to get my breastfeeding act right, immediately.
“This black part is supposed to go into his mouth! How?” I queried, blinking back the bitter tears of embarrassment and exasperation. Everything sounded so complex yet simple.
“You modern young mothers baffle me. In all my years as a midwife, I have never seen a generation as clueless as yours. Perhaps it is ‘The Facebook’. It has totally brainwashed you. You are too busy, staring at your phones, instead of giving your child the attention that he needs.” And with that remark, I was left to my own devices.
Never mind that I couldn’t find the correlation between my breastfeeding woes and ‘The Facebook.’ Perhaps she had seen too many of us new and ‘old’ mothers, camped up in the postnatal ward with our shrieking infants, and could not tell us apart. Furthermore, newborn babies look alike – like tired little old men and women. (No offence mom’s, I know we do not like to admit it, but truth be told, our little bundles of joy only begin to turn into cherubs after a few weeks/months post birth.)
From then henceforth, my breasts became severely engorged and felt like overripe melon about to burst out of my chest. The nipples started to crack and bleed. My son became extra cranky, like a hungry drill sergeant he kept wailing around the clock, and could not latch properly. Despite my best efforts, he also begun to lose weight. I could not shake off the feeling of being a failure.
Breastfeeding quickly turned into a blood, sweat and tears ritual for me. I would literally break into a cold sweat whenever my little one pouted his mouth in anticipation of a feed. I would offer him my breast to which he would suck eagerly from the cracked nipples, thus causing me pain that would shot throughout my entire body. The discomfort was unbearable. Nobody told me that a newborn baby has the appetite of 5 Bukusu men put together, and would need to feed 24/7.
Friends and family advised me to introduce him formula milk, so that I could save myself from the breastfeeding nightmare, and perhaps focus my energies and attention towards bonding with the young earthling. They knew that breast was best but in this instance they were willing to make concessions on my behalf. I was assured that formula feeding would not make me less of a mother (and indeed it doesn’t). However, I was determined to get past the agony and give my son the WHO recommended six months exclusive breastfeeding. If he would at least promise not to suck my soul through those cracked nipples.
This desire to keep breastfeeding in spite of the agony and low milk supply, led me to seek out the counsel of fellow mothers. I joined several Facebook support groups, and there I sought advice on latching, expressing and increasing milk flow. Many mothers were forthcoming with their experiences and opinions on what I should do to overcome the challenges that I was facing. Conversely, this only added more pressure to the stress and underachievement that I was already experiencing.
A friend later recommended that I seek the help of a professional lactation consultant. This was the first time I came across that term. I never knew that breastfeeding challenges could lead one to seek professional help. I contacted Susan Kamengere-Muriithi, a Lactation consultant and a Registered Nurse, working with Toto Touch. She is passionate about helping mothers and babies, and for that reason she graciously drove all the way from Nairobi at 4am, and was in Nyeri by 6am. She taught me these tips on how latch baby properly,breastfeed, proper management of cracked nipples, and overall techniques that helped me overcome the challenges of breastfeeding:
- The mother should be seated or lying in a comfortable position to avoid hunching and hurting the back, shoulder and neck muscles. Choose from either cradle hold, football hold (preferable if you have had a CS-section) or lying down breastfeeding positions (for night or relaxed feeds).
- Use a breastfeeding or ordinary pillow to support a newborn, so that the baby’s head and body are symmetrical and supported.
- The baby should be held close to mother’s body, preferably tummy-to-tummy or skin-to-skin contact. bring your baby from below, and not the breast to the baby.This will not only stimulate milk production but enhance bonding, especially with the eye contact.
- Support your breast with the first three fingers below the nipple while the index and thumb rest above it. Make sure that none of the fingers are either obscuring the nipple or baby’s mouth.
- Move baby’s head to the breast and make sure it’s tilted slightly back , not pushed into the breast, so there is enough space on the infant’s nose for comfortable breathing and suckling.
- Tickle the baby’s mouth with the nipple until he/sheopens it wide enough, like a yawn.His/her mouth needs to be wide open before latching the breast, indeed this is a fete that requires a lot of trial and error, and one is bound to obsess over the tiny mouth latch and perfect timing.
- Once the baby’s mouth is open, insert the nipple up to the areola and let the little one’s upper and lower lip turn outward, and the chin touch the breast.You will know the baby is latched properly is his mouth is pouted on the breast like a fish (‘fish lips’), and starts to instinctively suck and swallow.
- Once the baby’s mouth is open, insert the nipple up to the areola and let the little one’s lower lip turn outward, and the chin touch the breast.
- You will know the baby is latched properly is his mouth is pouted on the breast like a fish, and starts to instinctively suck and swallow.
- Pain while nursing means that the baby has not latched properly and is chewing on the nipple (ouch). If this happens, unlatch the baby not by pulling him off the breast, but by breaking the suction with your clean finger into the corner of his mouth. Redirect his hungry mouth into the nipple and areola.
I don’t know what I’d have done if I hadn’t sought professional help. Perhaps the pain and trauma would have inevitably led me to exclusively formula feed. I’m glad though that I asked for help. My son was able to exclusively breastfeed up to 6 months, and weaned himself off the beast at 8 months. I am of the belief that the services of a lactation consultant are invaluable. They made the rest of my breastfeeding time blissful, even when I had to sit up for frenzied feeds in a sleep deprived-vegetate state.
In retrospective, Kenyan hospitals should designate a lactation consultant to help navigate new mothers through the bewildering world of breastfeeding. I am of the impression that the midwives at my birthing hospital in Nyeri somehow expected me to have innate breastfeeding skills, even though this was my first child. Thus the lack of patience on their part. Lactation management and support services should be included in the maternity package (payable by NHIF or local insurance companies). Susan also recommends, that all first time mothers should seek the help of a lactation consultant or Breastfeeding Support Specialist as soon as one begins to experience trouble with breastfeeding. This would help a lot of mothers from the grief of poor breastfeeding techniques, underweight baby’s and the pain inducing-teeth gnashing mastitis that keeps mother’s from further breastfeeding.
Furthermore, “A newborn baby has only three demands. They are warmth in the arms of his mother, food from her breasts, and security in the knowledge of her presence. Breastfeeding satisfies all three.”
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