Biological Nurturing® and Late Preterm Babies
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Many posts on this blog is devoted to the concept of “laid-back breastfeeding,” but its main proponent, UK midwife and researcher Dr. Suzanne Colson, actually refers to her brainchild as “Biological Nurturing,” or BN for short. Is BN the same as laid-back breastfeeding…or is there more to it?
I’ve had the privilege of discussing this in depth with Suzanne during the past few months while we’ve labored together on a new DVD that Geddes Productions will release in May. Called “Biological Nurturing: Laid-Back Breastfeeding for Mothers,” this DVD shows mothers and babies using BN in the hospital, at home and even in an outdoor café.
When asked to describe BN, Suzanne is cautious about providing a strict definition, because she wants it to be something mothers discover with their babies. After being asked by countless mothers in my private practice if they were doing their breastfeeding holds “right,” I can understand her concern about being too specific. Here’s what she wrote for the DVD’s back cover:
Is BN breastfeeding in a laid-back position? Or is it about babies’ feeding reflexes? Perhaps it can be a kind of skin-to-skin contact. Actually, all of these are a part of Biological Nurturing, but there is so much more!
Biological Nurturing is as much about your relationship with your baby as it is about breastfeeding. It involves the sort of baby-holding and cuddling that many pregnant mothers dream about. Promoting continuity from womb to world by keeping mothers and babies together and comfortable, it features close body contact where mother-baby interactions work in harmony with gravity. These important factors are all related and interact to release an amazing cocktail of instinctive behaviors that help mothers and babies get started with breastfeeding.
After birth, BN naturally begins with skin-to-skin holding in laid-back positions, but later it also includes cuddling in these positions while lightly dressed.
In a 2003 study, Suzanne examined the effects of BN on early breastfeeding among 11 late preterm babies and one who was small for gestational age.1 To explain BN, the study mothers were told that since they couldn't put their babies down during their nine months of pregnancy, "it made physiological sense to incubate them in their arms" during the first days after birth. The midwife's primary job was described as helping "the mother realize she knew more about her baby than anyone."
With these instructions and this perspective, during the first 24 hours the study mothers kept their babies tummy down on their bodies in laid-back positions for between 4 and 16 hours, with a mean duration of breast contact of 7 hours and 40 minutes. This extended body contact naturally triggered breastfeeding behaviors in both mothers and babies and during this first day on average these mostly late preterm babies suckled actively for an amazing 2 hours and 35 minutes. Even while the babies slept, the mothers helped them to the breast and they fed actively without waking.
I had to wonder after reading this study if the root cause of many of the breastfeeding problems we see among late preterm babies is restricted mother-baby body contact. By keeping these babies in their own little beds most of the time, their feeding behaviors are not released, putting them at much greater risk of underfeeding.
More than just laid-back breastfeeding, BN includes the comfortable, close mother-baby body contact that that helps new mothers and their newborns become attuned to one another. Reflexes and instincts play a key role in deepening their bond. And as the mothers and babies in this new DVD demonstrate, all this leads to frequent early breastfeeding, the best possible start for everyone.
Reference
1Colson, S., DeRooy, L., & Hawdon, J. Biological Nurturing increases duration of breastfeeding for a vulnerable cohort. MIDIRS Midwifery Digest 2003;13(1), 92-97.
