Quality Early Lactation Care Is Critical for Newborn & Maternal Health
It's Everyone's Responsibility
This question from a mother who reached out to our local breastfeeding helpline really had me thinking.
She had just brought her 1-day old baby home and at some point realized it had been 6 or 7 hours since he fed.
He was just sleeping peacefully.
She had checked his breathing and he was very responsive if she stimulated him, but he wasn’t showing any hunger cues.
She searched online for someone to ask, and she found us.
I’m glad she did because we have IBCLCs staffing that line, so she got a call right away to check in on her.
Our on-call IBCLC (who also happens to be a registered nurse) talked her through this unsettling moment in her and her baby’s life, and she elicited plenty of contextual information about the situation.
Some great things: she got plenty of help at the hospital, her baby was born at term and at an average weight with no health issues, she was recovering normally and so was able to take baby home relatively quickly (with the support of her own mother for an extra set of hands), and so far the baby had been breastfeeding well.
In the Not Helpful category, no one talked to her about skin-to-skin.
She vaguely remembered having had the baby on her chest after he was born, but it was not for long, and no one told her she could do it again.
In fact, when the IBCLC asked if she had the baby swaddled, thinking maybe that was why he wasn’t showing hunger cues, she apologetically said no, she hadn’t done that since getting home from the hospital.
She thought she was SUPPOSED TO have the baby swaddled.
Of course, she thought that - that’s how the hospital staff handled her baby when she was there, so she assumed that was what she should do, too.
”Timing is everything.”
We hear that phrase all the time, in different contexts in our lives.
With newborns, timing IS everything.
That’s why I talk about the First 100 Hours so much.
What happens during this timeframe is monumental.
What we teach people about this timeframe can be life-changing.
To believe that someone was “supported to breastfeed” at the hospital when they were never taught skin-to-skin is a colossal failure.
If we want to create change and ensure that people have a fair shot at making their breastfeeding dreams come true, we need to start with the basics—and stick to the basics.
If this mother had not sought help from a highly trained and qualified IBCLC, she might have received very different suggestions.
Let’s face it: there’s a good chance she would have been advised to give the baby a little formula.
And some will say, well, a little formula won’t make a big difference.
There’s also an increasing chance (in our current developed-nation society) that she would have been told to pump.
I will never stop shouting this from the rooftops: those are NOT the first-line interventions for breastfeeding issues in the first 100 hours of a healthy, term newborn’s life.
They are not.
This matters a lot.
When we encourage new mothers to solve breastfeeding problems with tools like formula and breastfeeding devices instead of their own two hands and their bodies, we teach them that they are not enough.
It demonstrates in living color that they cannot do this huge thing that they feel in their soul that they are supposed to do.
It gives them “jobs” and tasks that add to their stress and limit their time for recovery.
It implants worry, doubt, and anxiety - and this is in our current population of childbearing folks who are already at high risk for developing mental health conditions or who already have them.
If we want to do better, we’ve got to implement a much better system.
I believe with all my heart that The First 100 Hours is the right thing to move our work forward.
It is all about timing and support in a very focused period and how what we do during that time has outsized impacts on the dyad.
Timing is everything.
The earliest hours and days of breastfeeding and lactation are critical for both new mothers and parents and their babies.
They should receive care from people specifically trained to offer targeted lactation support in the First 100 Hours of life.
Whether you work in a hospital or birth facility or with dyads who have already been discharged from the place of birth, you’ll know how to:
create a First 100 Hours timeline for the dyad
explain the First 100 Hours timeline and its significance
evaluate breastfeeding (within your scope of practice) and use the First 100 Hours Assessment Form to determine the dyad’s lactation needs
discuss and set lactation goals with the parent/client
create a lactation care plan with the parent/client, including making referrals for additional lactation care
What is abundantly clear from the evidence on early lactation care is that when dyads receive lactation guidance and assistance from trained individuals, they are more likely to meet their own breastfeeding goals.
We also clearly see how it is much easier to identify potential breastfeeding challenges earlier when trained individuals make early assessments and referrals.
I can’t wait to meet you and guide you through this very special course designed to increase your confidence and capacity to make a difference for dyads!