Breastfeeding Resources

At birth, most mammals move to their source of food and while this may seem like a nutritional issue, the process of moving from uterus to teat is an important transition in many ways. Some animals, in fact, will die if put at their mother’s teats by some well-meaning human helper. The process of getting to the source food is integral to the survival of mammalian neonates.

From an evolutionary point of view, once we became bipeds and the size of the human brain became too large to pass through the mother’s birth canal, birth had to take place earlier in the course of brain maturation. Human babies generally can’t manage this kind of locomotion until late in the second half of their first year of life. Looking at human developmental milestones in comparison to other mammals could lead one to the conclusion that human gestation doesn’t really end until about 9 months of age, in our terms.

If you follow this logic, then the first 9 months of a human babies life is really finishing normal gestation and optimum human development would take place in an environment with as many elements of the uterine environment as possible. It has been shown that babies kept skin to skin with their mothers show better oxygenation, better temperature control and a reduction of stress hormones which ultimately slow growth. This constant skin to skin environment most closely mimics uterine environment for the transition to life outside the womb.

Culturally, we are biased toward the idea of separation for new mothers and babies. In fact, incubators were developed to shield babies from their mothers as a source of infection. For a premature baby, the need for constant skin to skin care is even more critical and maximizes development of brain pathways, especially right brain growth in areas affecting perception of self and interpersonal relationships. The baby’s close contact with the mother also evoke more care giving responses in the mother which go far beyond
just providing nutrition by organized breastfeeding.

What has become known as Kangaroo Mother Care or generically “kangaroo care” actually started in the 1980’s in resource-poor areas where there were few incubators and warmers available for premature babies. Moms became a human incubator and survival and growth rates increased dramatically. Kangaroo care is used worldwide now because it offers such great benefits for all babies, premie or not. Dr. Nils Bergman at Mowbray Maternity Hospital in Cape Town, South Africa has made constant kangaroo care the standard of care even for tiny premies. Regardless of oxygen tubes and IV’s, mothers and babies are wrapped together for virtually 24 hours a day. The results after five years of data: survival of very low birth weight babies increased from 10% to 50%, and for 1500g to 2000g the survival had increased
from 70% to 90%.

Think of it from the baby’s point of view: laying on mom’s bare chest clad only in diaper and hat, between her breasts surrounded by the smell of her milk, right next to her heart, rocked by her breathing, warmed by her body. This mother will be aware of her baby’s needs without the baby resorting to distress cries often seen in babies separated from their moms. Premies grow faster, breastfeed earlier, have fewer breathing interruptions, handle pain with less stress, sleep better and go home from the hospital sooner. How’s that for a low-tech way to reduce health care costs?

“Kangarooing” is great for babies when they go home as well. Even at full term, babies are a bundle of immaturity and skin-to-skin time with mom or dad helps with calming and growing. Here’s some at-home tricks for parents and babies...
• if breastfeeding is getting off to a slow start, kangaroo time reinforces the baby’s strong instinct to breastfeed;
• if baby is difficult to wake for feeding, let baby nap on mom or dad’s chest; they will feel when baby stirs when baby may be more open to waking up to feed;
• if baby has had lots of bottles, lots of skin-to-skin will reawaken baby’s desire for the breast;
• if a woman’s mature milk seems slow to come in, she can give her body a boost with extra kangaroo care;
• if mom’s milk supply is low, adding kangaroo time to her pumping routine will help increase milk.

Best of all is the pure and peaceful joy of feeling their baby melt against them, soft breaths tickling at their skin. Drinking in this incredible time together is calming for everyone in the family.
Sue Petracek, IBCLC