Changing How We Teach Breastfeeding
Nancy Mohrbacher Tuesday, September 28, 2010 at 11:54AM We are experiencing a sea change in breastfeeding. But how quickly can we change our approach? At a breastfeeding conference last weekend, I summarized breastfeeding teaching strategies since 1980, 
how our understanding has evolved, and how this affects the way we help mothers.
In 1980, I was told to breastfeed my first baby by holding him in my arms with his tummy facing the ceiling, which I realize now was a bottle-feeding position. Over time, these instructions changed. Instead, we recommended mothers hold their babies “tummy to tummy.” To make latching easier, we suggested breast support using the “C” hold and “U hold.” We incorporated a variety of techniques for helping babies achieve an asymmetrical—or off-center—latch.
However, in 2008, U.K. researcher and midwife Suzanne Colson published an article indicating that some of our fundamental assumptions had been wrong. Not surprisingly, our “latching” or “attachment” instructions had been influenced by what we grew up seeing. Generations of bottle-feeding had convinced us that mothers needed to sit upright or lie on their sides to breastfeed their babies.
What changed? In her research, Colson identified 20 inborn reflexes that help babies breastfeed. And surprise! Like baby piglets and other newborn mammals, Colson found that these reflexes work best when our babies feed on their tummies. It turns out that all those years of teaching upright and side-lying breastfeeding positions may have been wrong-headed. Although our tried-and-true methods make sense in some situations, rather than using them sparingly, we taught all new mothers to breastfeed this way. As a result, gravity pulled babies away from their mothers’ bodies and made breastfeeding more challenging. Colson noted that as “positioning and attachment” techniques became more widely taught in the U.K., more new mothers gave up on breastfeeding early.
Colson’s research demonstrated that when mothers simply lean back and rest their babies tummy down on their semi-reclined bodies, most of our complicated latching instructions are no longer needed. In “laid-back” positions, gravity keeps mothers and babies touching and helps rather than hinders
breastfeeding.
Last week I spoke to a mother with a 5-day-old baby who at first had decided to formula feed because her baby wouldn’t take one breast and breastfeeding was just too hard. But then she felt her milk increase and decided to give it another try. Her goal was to do some breastfeeding and some formula-feeding. I told her about laid-back breastfeeding positions and steered her to http://www.biologicalnurturing.com/ to watch Suzanne Colson’s video clips. When we spoke again yesterday, her 10-day-old baby was now exclusively breastfeeding and she told me how much easier laid-back breastfeeding had been for her.
After my conference talk, many of my listeners—most of whom work with breastfeeding mothers every day—struggled to accept this new approach. Clearly much thought and reflection was needed before many could translate this knowledge into practice. Major paradigm shifts are never easy. But for the sake of mothers and babies, here’s hoping this one doesn’t take too long!
For more on laid-back breastfeeding, see my earlier post: http://www.nancymohrbacher.com/blog/2010/7/18/laid-back-breastfeeding.html
Reference
Colson, S. D., J. H. Meek, et al. Optimal positions for the release of primitive neonatal reflexes stimulating breastfeeding. Early Hum Dev 2008; 84(7): 441-9.
Reader Comments (16)
I am a big fan of Colson's ideas and techniques. We just bought a new couch and, even though I am well past my time of breastfeeding, thought "What a great couch to lean back and nurse on!"
Since seeing your conference session on this topic and since getting to know about Colson's work, I've changed the way I teach BF classes. However, it's all shot as soon as they get to the hospital (or once the old-school midwife assists them with BF) and get barraged with the techniques and how-to's from all sides. I make a point of talking about the merits of laid back BF to other professionals, so hopefully the tide will turn soon.
This article has made my day... I was told I was trying to bf incorrectly when this was the only way I could get my DD to bf. On the grounds that I had seen small creatures drinking whilst a child living on a farm it made sense to me that as long as there was no pain involved however a baby attached did not really matter as long as they put on weight. I was told many things that I now know to be wrong but what I would have given to have read this 4 years ago! Wow! Thank you.
I would imagine that "laid-back" nursing can really be helpful with managing overactive letdown. And it seems like it also helps babies build their neck/shoulder muscles! I was actually just watching the recent documentary film "Babies" tonight with my kids... it follows 4 babies on 4 different continents through their first year. All of the mothers were shown breastfeeding and one of the mothers was shown doing laid-back nursing!
I had never heard of this before. It's simply the way I breastfeed my children. I thought I was crazy. None of the positions that people were encouraging me to use worked, but we never had any problems at night. My babies just laid draped across my chest and belly all night. No wonder that was always easiest for us!
Nancy, I have been working with this for awhile and was at the conference on Saturday. I heard many around me who doubted what you were saying, but my families are living proof that it works. I work in a hospital as an IBCLC and even when others have given a mom many different things to try, when you bring out laid back breastfeeding, mom and baby figure it out.
No matter what has happened prior to my entering their room I FULLY trust that the mom and baby will find their way when given easy tools. This is the most incredible gift to give a family and begins to build confidence right away. I am not the key---the baby and mom are "hardwired" as you say, to breastfeed. I just help them see how to make it easier for them to do this together. I am a facilitator---the mom and baby are meant to fit together.
Folks, don't take my word for it----try it! I promise you won't regret it.
warmly,
Ann
I've been suggesting this often at work to mothers for the past two years. It is always thrilling and a privilege to watch. If it's a baby who's not been opening well, almost every time the mother is exclaiming, "This is the most he's opened his mouth since he was born!"
That's odd. My baby tried this, but I found it very uncomfortable. She'd latch on well with her mouth, but the weight of her head flopped on my breast was intolerable. If it works for others that's great of course.
Interesting advice! I never encountered it before, but I am still breastfeeding at 21 months! :D
This is great! in five years i cant believe i've never tried this! My five year old says he enjoys the new style very much, as do I. :D It's wonderful!
Here via Mother in Israel :)
This is so interesting -- I was sure my daughter had invented this idea!
While breastfeeding twins 20 years ago, I often used laid back breastfeeding positions. You practically have to in order to get two latched on at the same time. It especially works as they get bigger. I spent many hours nursing twin toddlers in a a laid back position whether in a recliner, the bed or a pallet on the floor. Happy memories!
Great post. Thanks for sharing your experience. Religion would tell us that we should enjoy the cage and then if we do God would move you to a bigger and better cage :D If we are impatient with the cage then we are unenlightened, relbellious jerks...Cheap Classics
Great post. Thanks for sharing your experience. Religion would tell us that we should enjoy the cage and then if we do God would move you to a bigger and better cage :D If we are impatient with the cage then we are unenlightened, relbellious jerks...Cheap Classics
I've had some trouble lately with my older baby's teething (8 months) and our BFing. He has a tooth coming in at a very funny angle and I can feel it when we nurse. I also have overactive let down, so he tends to revert to a 'nibble at the nipple' when the let down starts, even though I make sure that we're latched on properly when we begin nursing. Laid-back positioning has been a life-saver for me! When we nurse in this position, I can't feel his crooked tooth (which I hope will straighten as it comes in more!!!), and the overactive let down isn't a problem so he doesn't nibble! In short -- IMO laid-back is not just for newborns!!!
Terrific job! The feedback given was great. I really hope that you keep up the excellent job executed.
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