Breastfeeding - New Reclining Technique

Lactation consultant Nancy Mohrbacher discusses a new reclining technique to make breastfeeding easier for new mums. 

Few mums will forget the pain of those early days of breastfeeding — the toe-clenching moments when baby first begins to suck. Usually this pain lasts only a moment or two and, over time, most women and their babies learn the knack of comfortable and satisfying feeding. However, for some women, these difficulties spell the end to breastfeeding.

Nipple pain and milk supply issues are the main reasons new mums give up, says lactation consultant Nancy Mohrbacher. But a lot of that is to do with breastfeeding “myths” and parental expectations of how their babies will feed, she says.

Nancy, a US-based author, is at the forefront of a new push to make breastfeeding easier for new mums and their babies. Her book deals with the seven most common breastfeeding problems: Latching struggles, worries about milk supply, nipple and breast pain, along with night feeds, expressing milk and weaning.

Nancy herself “fell in love” with breastfeeding when her own children came along in the early 1980s and was deeply involved with La Leche League. Ten years later she had become a lactation consultant and in recent years has written several books on feeding. Breastfeeding Solutions is the latest and in it she promotes a new latching technique. The technique is based on research in the UK from 2008 which is now gaining traction in other parts of the world as a way to make feeding easier.

Essentially, it’s about semi-reclining to feed baby. With gravity on your side, your newborn has a natural advantage in getting a proper latch. Of course, you do need to make sure you’re propped up on cushions or generally supported in this position so you can relax.

When in the laid-back position, your baby’s body can rest comfortably on your tummy and there’s no need for you to support his body while he feeds, Nancy writes in Breastfeeding Solutions.

“Also, gravity works with your baby’s reflexes to help him get on the breast deeply, which triggers active suckling and helps him settle quickly.”

The laid-back approach is a good starting point for new mums, Nancy says on the phone from Chicago.

“It’s like training wheels on a bike — it makes it easier for mums and babies in the beginning — it puts more odds in their favour.”

And since she’s started recommending this technique, for the first time in her career she’s found that as a lactation consultant she can help mums with latching problems over the phone rather than seeing them in person.

“It’s relatively simple. There aren’t so many steps or the need for micro-managing.” 

Here’s how it works
Sitting upright in a chair (which can also be hard-going for Mum after a painful vaginal birth) means that gravity is pulling baby’s body away from the breast, making latching on harder. It requires you to lift baby up and into the right position (cue demand for a large number of cushions). This position also makes baby’s reflexes behave in a less than helpful manner (head-bobbing, kicking, body arching) because gravity is working against him.

When you first start breastfeeding, it often seems that nothing works. And in desperation you try the rugby hold but still baby can’t seem to stay on the boob.

The new technique of laid-back feeding was initiated by UK midwife Suzanne Colson in 2008 and is also known as biological nurturing. It’s said to kick off reflexes in the baby which act as breastfeeding stimulants.

But it’s not just about feeding. The idea is for Mum to hold and cuddle her child in comfort.

Suzanne Colson writes in Midwifery Today (www.midwiferytoday.com) “There is no lining up of body parts and no ‘correct’ breastfeeding procedures. Instead, mothers hold their babies for as long, as often and with as much skin-to-skin contact as they want.”

Latching onto the breast properly is a bigger issue for today’s mums than it was 30 years ago when Nancy became involved in supporting new mums.

It could well have led to a commonly held belief that some babies just don’t like breastfeeding, she says.

Not true. Babies are hard-wired to breastfeed but that doesn’t mean there won’t be teething problems. 

Myth-busting
There are many myths that Nancy is keen to dispel and most are about how parents expect their babies to feed, but a lot of these expectations are based around bottle-feeding and growing up with babies who were bottle-fed.

“Many women are unfamiliar with breastfeeding norms,” she says.

They expect their babies to feed regularly, say, three-hourly, and are completely unprepared for cluster feeding when baby seems to want to feed constantly for hours.

This is actually normal for babies under six weeks, says Nancy. But if you’ve been exposed only to bottle-feeding, you might think something’s going wrong.

“Mothers think they don’t have enough milk so they start to supplement but [cluster feeding] is completely normal in the first six weeks.”

As she writes, “When breastfeeding is going normally, small feedings during the first six weeks often translate to periods of very frequent and sometimes non-stop breastfeeding. Unlike many babies fed by bottle, most breastfed newborns do not feed at regular time intervals. While it is true that most young babies breastfeed eight to 12 times every 24 hours, the usual laws of mathematics don’t apply here.” 

Sore nipples
Nancy says it’s a myth that nipple pain must be accepted as a part of breastfeeding. While some mothers may have tenderness for a week or two, if it lasts longer than that you need to seek help or change the way you feed. In most cases a deeper latch will fix problems, writes Nancy. So try to get baby to take a full mouthful of breast tissue.

You’ll know if he’s latched on too shallowly — your nipple may come out squashed-looking or pointed. Again, Nancy recommends the laid-back or semi-reclined position to help baby get a deeper latch.

“You’ll know you have reached the comfort zone when breastfeeding feels more comfortable than before. If you have nipple trauma, breastfeeding may not yet feel completely comfortable. But any reduction in pain indicates baby has a deep latch,” she writes. 

My baby’s not gaining weight
Few words are likely to strike fear in the hearts of breastfeeding mums as much as those above. After weeks of trying to grow your baby, finding out that that growth may not be fast enough could turn your thoughts to formula.

But really, if you’ve been told that your baby’s place on the growth chart is at the lower percentile — is that cause for concern? asks Nancy.

Some children are chunky and some are small-framed, regardless of how well they feed. She says the important factor is consistent weight gain over weeks and months. “If a baby is gaining consistently and well, his actual percentile is irrelevant. But if over time his percentile drops, this would be a reason to take a closer look at breastfeeding to see if adjustments are needed.”

So, the message is… don’t give up. Hang in there. There are so many sound reasons to breastfeed your baby for his short-term and long-term health — even if he doesn’t thank you for it later. 

Breastfeeding Solutions by Nancy Mohrbacher, RRP$34.99. Published by New Harbinger. Distributed by bookreps.co.nz