Nursing Is Much More Than Milk

When discussing lactation, the health effects of human milk often get top billing, but nursing gives children much more than calories and immune-boosting ingredients. Nursing provides sensory stimulation that enhances infant neurodevelopment.[1] It is one of baby’s first social interactions. The sucking of nursing calms and comforts little ones during fussy periods and meltdowns, which is why some call nursing an “all-purpose parenting tool.” Although some consider “nursing for comfort” unimportant, its positive effects are clear. Not only is it “okay” to use nursing as a way of comforting a baby, this can play an essential role in child development. Read on for more details.

Nursing on Cue and Parent-Child Synchrony

How do parents know it’s time to nurse? Health organizations recommend nursing whenever baby shows early feeding cues (rooting, hand-to-mouth, fussiness) rather than on a schedule.[2] One way to describe this approach is nursing on cue, and most lactation supporters know that this strategy is the best way to achieve both healthy growth for baby and healthy milk production. (If a nursing newborn is not gaining weight as expected, a sleepy baby may need extra stimulation to nurse more actively, as described HERE. During the first 2 weeks, babies need to be monitored closely to make sure they’re feeding effectively. With a healthy weight gain, it’s no longer necessary to track feeds and diaper output, as is often emphasized in the hospital.)

When parents nurse on cue, offering to nurse as the first response to a fussy baby is always appropriate. When nursing is offered, sometimes baby will nurse. Sometimes baby will prefer another soothing technique or something else. Nursing on cue simplifies life with a baby, in part because it meets so many of baby’s needs. Especially during the first year, with regard to nursing, what a baby wants generally coincides with what they need, so it is easy for parents to trust baby’s cues.

Simplifying life with a baby is always a plus, but another benefit of responsive, cue-based parenting is that it promotes something scientists call parent-child synchrony. Researchers describe synchrony as harmonious, rhythmical interactions that involve mutual and reciprocal behaviors.[3] When parent and child are “in sync,” they respond to each other intuitively. This synchrony—or lack of it—is the first of a baby’s essential life lessons on what it means to be human. Stronger parent-child synchrony is linked to better mental and physical health in both parents and children. And cue-based care is associated with greater synchrony.

Getting in Sync: How and Why

Getting in sync with a baby involves focusing on a simple goal: keeping baby calm and comfortable as much as possible. Some describe this as “helping babies keep their stress levels dialed down,”[4] which is something most new parents do instinctively. Getting in sync often begins at delivery with immediate skin-to-skin contact, which is promoted in many birthing facilities because it helps vulnerable newborns better regulate their body temperature, blood sugar, heart rate, and breathing, easing the transition from womb to world.[5] After birth, if a newborn’s stress levels get dialed up and stay that way, over time this causes physical changes, such as lower blood sugar levels, which increase the risk of health problems such as hypoglycemia.[6] Just as in adults, the more often and longer babies experience high stress levels, the greater the risk of physical and mental-health problems.

Soothing a fussy baby may seem like the simple, obvious response, yet many don’t realize that these behaviors also play a profound and complex role in baby’s development. In an overview article, US neuropsychoanalyst Allan Schore noted that when parents and babies interact—nursing, talking, looking into each other’s eyes, touching—this creates a direct, intimate brain connection between them during which the adult helps regulate baby’s state (i.e., fussy, calm). Schore explained that the resonance between the parent’s and child’s brains allows the baby’s immature nervous system to be “co-regulated by the caregiver’s more mature and differentiated nervous system.”[7] 

Because every baby is different, getting in sync involves experimenting with calming strategies to find those that work best with that specific baby. For many babies, the nurturing and comforting aspect of nursing is a key part of this. Very quickly, new parents become the experts on what their baby needs to stay calm and content most of the time.

Fortunately, perfection is not required for strong synchrony. Simply doing our best is good enough. Employed parents can ask baby’s caregivers to feed on cue and comfort baby when needed. And it’s never too late. If a baby spends time in the NICU after birth, responsive parenting can begin at home. For an adopted baby, it can begin after baby is placed with the new family.

What are the broader, long-term effects of responsive, cue-based parenting? Studies found it teaches children how to handle stress and strong emotions. It teaches them about compassion and how to relate to others.[3] One U.S. study of 101 6-month-old babies and their mothers found that strong mother-baby synchrony was associated with better mental and psychomotor development at 9 months.[8] In other studies, responsive parenting was linked to greater emotional resilience in children and later in life with fewer mood and anxiety disorders, as well as fewer serious psychiatric problems.[9] Some parents worry that responding to their children freely and providing comfort as well as food may create an unhealthy dependence, but the opposite is true.

A review of the literature on parent-infant synchrony concluded that parents in sync with their babies had a closer emotional bond. This bond helped children learn to better manage their emotions. It also concluded that greater parent-child synchrony improves a child’s ability to learn language and develop healthy relationships with others.[10]

But responsive parenting has benefits for parents, too. According to this same review of the literature, after a new baby’s arrival, a cue-based parenting style made adjusting to parenthood easier. Responsive parents in sync with their babies enjoyed this closer relationship and felt a greater sense of competence. They were also at reduced risk of depression and anxiety and were less likely to adopt a more controlling and negative parenting style, which could put them at odds with their child.

Nursing fits naturally into this bigger picture, even partial nursing in families where babies receive substantial nourishment from nonhuman milks. In addition to sucking dialing down baby’s stress levels, the hormones released during nursing make it easier for parents to get in sync with their baby. A US study used MRIs to examine brain activity in nursing and non-nursing mothers and found that nursing mothers showed greater activation of the brain regions associated with nurturing behaviors and empathy, as compared with the non-nursing mothers.[11] A Dutch study found a link between duration of nursing, responsiveness and more secure attachment. [12]

Origins of Conflicting Advice

If responsive parenting is so good for families, why do some authors and online resources recommend feeding schedules and caution parents against letting baby “use them as a pacifier” (for more on this click HERE). To put this advice in context, it may help to understand its origins.

A less responsive approach to parenting arose in the 1920s, when for the first time, male scientists began providing families with child-rearing guidance. Before this, parents turned mainly to their female family and friends for advice. These emerging experts drew from the science of behaviorism to promote unproven baby-care strategies known collectively as scientific mothering. This approach involved feeding babies (even newborns) on a strict 4-hour schedule. They cautioned parents to avoid holding their babies too much to prevent “spoiling.”[13] They advised parents to be unresponsive to their baby’s cries to prevent their babies from “manipulating” them, which they claimed would eventually result in less crying.

In the 100 years since scientific mothering first debuted, these strategies were studied and found both ineffective and potentially harmful. But over time, these ideas seeped into the Western cultural fabric. Some aspects of scientific mothering are still present today. Examples include the idea that schedules are good for babies (even though babies have no sense of time), that tiny babies can manipulate parents by crying (despite lacking the thought processes necessary to do so), that self-soothing needs to be taught (this occurs naturally as babies grow and develop), and that too much holding can “spoil” a baby (disproved in cultures where babies are routinely kept close). 

When deciding on your own approach to baby care, keep in mind that today’s recommendations for cue-based care come from solid evidence. Research found years ago, for example, that when parents respond to their babies’ crying rather than ignoring it, this results in less crying over time, not more.[14]  

The biggest downside of scientific-mothering is that rather than parent and child being on the same team, it puts parents and children in opposition to one another, encouraging parents to mistrust their child. If parents need to be on guard against their baby “using” or “manipulating” them, this can undermine their relationship with their baby and indeed their whole outlook on parenthood. Who needs this kind of negative attitude toward their baby? Even without it, early parenting is challenging enough.

Nursing Without Worry

Negative messages about creating “bad habits” by nursing on cue or comforting a baby with nursing are rooted in scientific mothering and have no basis in fact. There’s no doubt that caring for a newborn can sometimes feel overwhelming, and adopting a less-responsive approach may sometimes sound tempting. Peer support, especially during the first 6 weeks, helps many families navigate these challenges in a more positive way. (See my video account HERE of my rough evening of nonstop nursing during my oldest child’s intense first 40 days.)

But even when nursing and newborn care are stressful and exhausting, being responsive to your baby brings its own rewards. Many families find that nursing and cue-based care make life more rewarding for everyone. Those same hormones that help you get in sync with your baby can soothe and relax you during the rough times. While it sometimes feels as though babies will need this kind of nonstop day-and-night parenting forever, this intense need lasts only a very short time in what will be a long and loving relationship. Perhaps someday your children will even thank you for it, but probably not until they have children of their own.   

References

1  Bergman, N. (2017). Breastfeeding and perinatal neuroscience. In C. W. Genna (Ed.), Supporting Sucking Skills in Breastfeeding Infants (3rd ed., pp. 49-63). Burlington, MA: Jones & Bartlett Learning.

2  AAP. (2012). Breastfeeding and the use of human milk. Pediatrics, 129(3), e827-e841.

3  Leclere, C., Viaux, S., Avril, M., et al. (2014). Why synchrony matters during mother-child interactions: A systematic review. PLoS One, 9(12), e113571.

4  Ball, H. L., Douglas, P. S., Kulasinghe, K., et al. (2018). The Possums Infant Sleep Program: Parents’ perspectives on a novel parent-infant sleep intervention in Australia. Sleep Health, 4(6), 519-526.

5  Moore, E. R., Bergman, N., Anderson, G. C., et al. (2016). Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database of Systematic Reviews, 11, CD003519.

6  Takahashi, Y., & Tamakoshi, K. (2018). The positive association between duration of skin-to-skin contact and blood glucose level in full-term infants. Journal of Perinatal & Neonatal Nursing, 32(4), 351-357.

7  Schore, A.N. (2001). The effect of early relational training on right-brain development, affect regulation, and infant mental health. Infant Mental Health Journal, 22(1-2), 201-269.

8 Evans, C. A., & Porter, C. L. (2009). The emergence of mother-infant co-regulation during the first year: Links to infants’ developmental status and attachment. Infant Behavior and Development, 32(2), 147-158.

9  Swain, J. E. (2011). Becoming a parent: Biobehavioral and brain science perspectives. Current Problems in Pediatric and Adolescent Health Care, 41(7), 192-196.

10  Baker, B., & McGrath, J. M. (2011). Maternal-infant synchrony: An integrated review of the literature. Neonatal Paediatric and Child Health Nursing, 14(3), 2-13.

11  Kim, P., Feldman, R., Mayes, L. C., et al. (2011). Breastfeeding, brain activation to own infant cry, and maternal sensitivity. Journal of Child Psychology and Psychiatry, 52(8), 907-915.

12  Tharner, A., Luijk, M. P., Raat, H., et al. (2012). Breastfeeding and its relation to maternal sensitivity and infant attachment. Journal of Developmental & Behavioral Pediatrics, 33(5), 396-404.

13  Watson, J.B. (1928). Psychological Care of the Infant and Child. W.W. Norton & Company: New York, NY.

14  Crockenberg, S. and McCluskey, K. (1986). Change in maternal behavior during the baby’s first year of life. Child Development, 57:746-753.