One of the major sources of frustration and even guilt in early motherhood is breastfeeding. Yes, for some mothers breastfeeding runs utterly smoothly, but for others, breastfeeding challenges become a partially painful and uneven ordeal. The range of complaints includes cracks and fissures in the nipples, sore breasts, infections, fungi, concerns with having enough milk, and feelings of having to feed too frequently and thus becoming a milk-producing machine. These conditions make breastfeeding less of the pleasant bonding activity which most mothers envision for their unborn child. So, what can help these mothers? Perhaps a few breastfeeding tips and education.
First Recourse: Mastering the Basics
The first recourse or breastfeeding tip is naturally to make sure that the basics are in place. There is plenty of literature out there, which an expectant woman can read at her own leisure. The website of La Leche League is a very good on-line source of information. La Leche League has also published a good and thorough book “The Womanly Art of Breastfeeding.” However, if the baby is already there, and the mother feels overwhelmed by the many demands of the little one, calling on a lactation consultant could be a wise measure.
Mastering the Fundamentals
The basics of breastfeeding include finding a proper position that suits you and your baby, so you both can relax. This may involve some experimenting, including propping yourself and your baby up with pillows.
The proper latching on of the baby to the mother’s breast is of fundamental importance and can make all the difference in the world, not least when breastfeeding is experienced as painful.
Being aware that the composition of the milk changes during each feeding helps too. The milk will change from being relatively light to become richer in fat during each feeding. The first part of the feeding serves to quench the baby’s thirst, the latter part to satisfy her or his hunger. Ending off a feeding prematurely will force the baby to demand more frequent feedings and thus less breaks for the mother.
Ending off the feeding prematurely can also lead to sore breasts and, eventually, also inflammations of the breast. When the milk is made to stagnate it can mess up the finely tuned system.
Beyond the Basics: Unraveling the Persistence of Pain
Having adopted all these fundamentals, and even after enlisting the help of a professional lactation consultant, some women, however, still experience breastfeeding challenges such as intermittent or persistent pain. Some women experience brief periods where the breastfeeding lives up the pleasant expectations, interrupted by periods where breastfeeding challenges become a painful source of frustration.
It is like a pendulum swing, going back and forth. For some women, having exhausted the sources of help and external advice, the pain and frustration becomes unbearable and breastfeeding becomes more of a threat to the bond of love and pleasure that any mother hopes to form with her baby. They then make the decision to switch to formula milk; a decision that should be respected.
Insights into Oxytocin: A Key Player in Breastfeeding Pleasure
For some mothers the pain is sufficiently bearable for them to persist in breastfeeding and most will report that after a period ranging from a few weeks to several months, breastfeeding becomes the smooth and mutually pleasant bonding experience which they were hoping for.
The scientific literature on breastfeeding offers relatively little direct insight into the possible mechanisms underlying these large variations in the breastfeeding experience.
However, one candidate mechanism seems to involve the birth and breastfeeding hormone oxytocin. Oxytocin is the hormone that causes the uterus to contract during labor and birth. It is also responsible for the milk let-down mechanism by making the muscle cells surrounding the breast’s milk producing glands contract.
Oxytocin: More Than a Milk Let-Down Mechanism
These are the classical and well-known effects of oxytocin, however, research in the past two decades has shed light on some highly interesting and relevant effects of oxytocin.
The level of oxytocin in the body seems to correlate inversely with the level of stress hormones, heart rate and blood pressure. The more oxytocin you have flowing around in your body, the less stressed you are likely to be. And we know that stress is very counterproductive to breastfeeding. Oxytocin also seems to work as a pain reducer. So, the more oxytocin you have in your body, the greater your tolerance will be towards pain.
Oxytocin’s Influence on Parenting Quality
What is even more interesting is the correlation between levels of oxytocin in the parent’s blood and saliva and the quality of parenting that they are able to provide. High oxytocin parents seem to be more in tune with their babies and they derive more pleasure from their interactions with their baby, which then turns into a virtuous circle. Interactions with the baby are simple, straightforward, uncomplicated and fun.
What the researchers have recently established is that in any given group of human parents, there will be variations in the naturally occurring levels of oxytocin in their blood and in their saliva. Some parents will, for reasons as of yet unknown, have high levels of oxytocin, others will have low levels.
Influence on Baby: Oxytocin’s Effects in Infants
The good news is that there is circumstantial evidence that it is possible to influence the levels of oxytocin in a human body. One tried and tested approach to difficulties with initializing breastfeeding is to have the mother engage in skin-to-skin contact over a period of several days. This will normally cause the oxytocin level to increase and thus stimulate the milk let-down reflex.
In one study, the researchers examined the effects of prolonging the period where the mother involved herself in skin-to-skin contact with the baby. During the first week the mother would engage in skin-to-skin contact for approximately five hours a day, and in weeks two through five, two and a half hours a day. Interestingly, of the women who initiated breastfeeding after birth, the amount of breastfeeding women in the skin-to-skin contact group remained the same after three months, presumably meaning that not one single skin-to-skin mother had ceased breastfeeding at three months. In the control group, some 23% had given up at three months.
It is thus very likely that the extended physical contact caused the oxytocin levels to rise in the skin-to-skin mothers, and thus helped make breastfeeding a pleasurable experience, prompting the mothers to continue.
Oxytocin’s Impact on Nutrient Uptake in Infants
Curiously, oxytocin also has effects in the baby. Experiments in animals have shown that oxytocin works in two ways as regards nutrient uptake.
First, when the level of oxytocin is high, the pups will be able to go longer without food, without displaying signs of hunger. The theoretical consequences of that for a breastfeeding mother ought to be obvious. If she can assist in increasing her baby’s oxytocin level by providing physical contact (ideally skin-to-skin) her baby will be able to go longer without food, thus reducing the demands on the mother’s time.
Secondly, if a group of pups is taken away from the mother, divided into two groups, where one group is caressed daily by a research assistant (and thus affecting the level of oxytocin) and the other left alone, the caressed group will utilize the supplied nutrients far better than the untouched group. So even though the two groups are given the exact same amounts of nutrients, the caressed group will grow faster. This could explain why some children are growing faster than others – having been exposed to more physical contact, their oxytocin level is higher and they therefore utilize the nutrients of their mother’s milk more efficiently.
In summary, oxytocin seems to affect breastfeeding more broadly than hitherto assumed. The effects of oxytocin on breastfeeding are not simply reduced to the milk let-down reflex, but affect a number of other supporting mechanisms, which in the end will assure that the breastfeeding experience is the pleasant and mutually rewarding experience that every mother is hoping for.
The key to utilizing this insight is to expose yourself as a breastfeeding mother to extensive skin-to-skin contact, carry your baby on your body, look into her or his eyes, take in her or his lovely smell, and soon you will be successfully breastfeeding your baby.
